MEDICARE: NEVADA COMMUNITY CARE LLC

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	261QP2300X	Primary Care Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1619576964
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVADA COMMUNITY CARE LLC

Provider Business Mailing Address
First Line	:	3615 SW 138TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-7227
Country	:	US
Telephone Number	:	702-553-5033
Fax Number	:

Provider Business Practice Location Address
First Line	:	3430 E FLAMINGO RD STE 224
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5065
Country	:	US
Telephone Number	:	702-742-5496
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. YADISNAY GUADALUPE GARCIA
Credential	:
Telephone Number	:	702-553-5033

Provider Enumeration Date	:	10/19/2020
Last Update Date	:	02/20/2025

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Directions to “NEVADA COMMUNITY CARE LLC ” Practice Location

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