MEDICARE: MOZO HEALTH & WELLNESS CLINIC 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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1780542738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOZO HEALTH & WELLNESS CLINIC LLC

Provider Business Mailing Address
First Line	:	7575 W WASHINGTON AVE STE 127-136
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-4333
Country	:	US
Telephone Number	:	786-262-6408
Fax Number	:

Provider Business Practice Location Address
First Line	:	4680 S EASTERN AVE STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6192
Country	:	US
Telephone Number	:	786-262-6408
Fax Number	:

Authorized Official
Title or Position	:	OWNDER
Name	:	LEOPOLDO C MOZO SOLER
Credential	:
Telephone Number	:	786-262-6408

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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