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NPI Code Detail

MEDICARE: SARA MARISOL GORDILLO TECH

MEDICARE: SARA MARISOL GORDILLO TECH
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
1246W00000XCardiology Technician1221244NV
2246RP1900XPhlebotomy Technician1221244NV

General Provider Information

NPI Number : 1578385712
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA MARISOL GORDILLO TECH
Provider Business Mailing Address
First Line : 15791 BEAR CREEK PKWY APT A430
Second Line :
City : REDMOND
State : WA
Zip : 98052-1518
Country : US
Telephone Number : 747-305-0032
Fax Number :
Provider Business Practice Location Address
First Line : 8410 RAFAEL RIVERA WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-5391
Country : US
Telephone Number : 702-567-1920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2024
Last Update Date : 10/29/2024

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Directions to “ SARA MARISOL GORDILLO TECH” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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