# MEDICOTEK INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDICOTEK INC
- **Other names:** OPTIMA HEALTHCARE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790450104
- **Legal business name:** MEDICOTEK INC
- **Authorized official:** MARIVIC LUNA BANAL (DIRECTOR)
- **Authorized official phone:** (702) 778-4838

## Contact information

- **Practice address:** 6859 S EASTERN AVE STE 103, LAS VEGAS, NV 89119-0003
- **Practice address phone:** (702) 778-4838
- **Mailing address:** 6859 S EASTERN AVE STE 103, LAS VEGAS, NV 89119-0003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 261QR0200X | Radiology Clinic/Center | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/09/2021
- **Last updated:** 10/27/2021