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NPI Code Detail

MEDICARE: JOEL C VIRTUDAZO FNP-C.FNP-BC

MEDICARE:   JOEL C VIRTUDAZO  FNP-C.FNP-BC
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
1363LF0000XFamily Nurse Practitioner890078NV

General Provider Information

NPI Number : 1700677887
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOEL C VIRTUDAZO FNP-C.FNP-BC
Provider Business Mailing Address
First Line : 26 SNOW POND AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-5137
Country : US
Telephone Number : 702-682-7267
Fax Number :
Provider Business Practice Location Address
First Line : 26 SNOW POND AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-5137
Country : US
Telephone Number : 702-682-7267
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2025
Last Update Date : 05/16/2025

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Directions to “ JOEL C VIRTUDAZO FNP-C.FNP-BC” Practice Location

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