MEDICARE: LALITA OTTAVIANI

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	253Z00000X	In Home Supportive Care Agency	891080	NV

General Provider Information

NPI Number	:	1912878968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LALITA OTTAVIANI

Provider Business Mailing Address
First Line	:	4032 COMPASS ROSE WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-5400
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4032 COMPASS ROSE WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-5400
Country	:	US
Telephone Number	:	702-927-4586
Fax Number	:

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

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	09/15/2025

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Directions to “ LALITA OTTAVIANI ” Practice Location

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