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NPI Code Detail

MEDICARE: MADELAINE LAZO-CHINEA

MEDICARE:   MADELAINE  LAZO-CHINEA
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
1376J00000XHomemaker20161065817NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598242547
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELAINE LAZO-CHINEA
Provider Business Mailing Address
First Line : 7300 LA MONA CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0541
Country : US
Telephone Number : 702-802-9058
Fax Number :
Provider Business Practice Location Address
First Line : 4550 W OAKEY BLVD STE 111-O
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1581
Country : US
Telephone Number : 702-861-0238
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2018
Last Update Date : 07/23/2018

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Directions to “ MADELAINE LAZO-CHINEA ” Practice Location

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