MEDICARE: PROSSAVID HEALTH CARE CENTER L C

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1619110350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROSSAVID HEALTH CARE CENTER L C

Provider Business Mailing Address
First Line	:	3365 E FLAMINGO RD STE 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-7440
Country	:	US
Telephone Number	:	702-764-7765
Fax Number	:	702-552-5160

Provider Business Practice Location Address
First Line	:	3365 E FLAMINGO RD STE 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-7440
Country	:	US
Telephone Number	:	702-764-7765
Fax Number	:	702-552-5160

Authorized Official
Title or Position	:	FNP/CEO
Name	:	DR. ADRIAN CASTILLO MILANES
Credential	:	DNP
Telephone Number	:	702-488-0544

Provider Enumeration Date	:	04/10/2009
Last Update Date	:	10/08/2025

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