MEDICARE: ELINA CASARES-CUELLAR

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1558711267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELINA CASARES-CUELLAR

Provider Business Mailing Address
First Line	:	2309 DEMETRIUS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-1424
Country	:	US
Telephone Number	:	702-572-1877
Fax Number	:

Provider Business Practice Location Address
First Line	:	2309 DEMETRIUS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-1424
Country	:	US
Telephone Number	:	702-572-1877
Fax Number	:

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

Provider Enumeration Date	:	06/14/2016
Last Update Date	:	06/14/2016

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Directions to “ ELINA CASARES-CUELLAR ” Practice Location

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