MEDICARE: SOCRATES FELIPE PIZA BERNAL P.A.

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	363A00000X	Physician Assistant	3029	PR
2	363AS0400X	Surgical Physician Assistant	3029	PR
3	246ZC0007X	Surgical Assistant	23-581	NV
4	363AM0700X	Medical Physician Assistant	3029	PR

General Provider Information

NPI Number	:	1891570016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOCRATES FELIPE PIZA BERNAL P.A.

Provider Business Mailing Address
First Line	:	1564 TANGERINE ROSE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89142-0975
Country	:	US
Telephone Number	:	702-750-5782
Fax Number	:

Provider Business Practice Location Address
First Line	:	1564 TANGERINE ROSE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89142-0975
Country	:	US
Telephone Number	:	702-750-5782
Fax Number	:

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

Provider Enumeration Date	:	08/28/2023
Last Update Date	:	02/10/2026

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