MEDICARE: ALEXA DANIELLE VAZQUEZ

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	251E00000X	Home Health Agency	894114	NV

General Provider Information

NPI Number	:	1932063302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXA DANIELLE VAZQUEZ

Provider Business Mailing Address
First Line	:	3437 GOLDEN SAGE DR
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-2418
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3437 GOLDEN SAGE DR
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-2418
Country	:	US
Telephone Number	:	702-764-9621
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “ ALEXA DANIELLE VAZQUEZ ” Practice Location

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