MEDICARE: ALEJANDRO PORTUONDO DC

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	111N00000X	Chiropractor	B01534	NV

General Provider Information

NPI Number	:	1811314982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO PORTUONDO DC

Provider Business Mailing Address
First Line	:	6372 MCLEOD DR STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-4415
Country	:	US
Telephone Number	:	702-879-4455
Fax Number	:	702-850-2548

Provider Business Practice Location Address
First Line	:	6372 MCLEOD DR STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-4415
Country	:	US
Telephone Number	:	702-879-4455
Fax Number	:	702-850-2548

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2014
Last Update Date	:	04/26/2023

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Directions to “ ALEJANDRO PORTUONDO DC” Practice Location

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