MEDICARE: DR. ALAINA LYNN LAVINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	791	NV
2	152W00000X	Optometrist	14618	CA

General Provider Information

NPI Number	:	1508206236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAINA LYNN LAVINE

Provider Business Mailing Address
First Line	:	6620 N DURANGO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4430
Country	:	US
Telephone Number	:	702-227-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	6620 N DURANGO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4430
Country	:	US
Telephone Number	:	702-227-2020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2013
Last Update Date	:	09/04/2014

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