Individual
IVETTE M ORTIZ SOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1409 E LAKE MEAD BLVD, NORTH LAS VEGAS, NV 89030-7120
(702) 649-7711
Mailing address
612 TIMBERFALLS LN, HENDERSON, NV 89015-5834
(787) 405-7299
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10191
AZ
363A00000X
Physician Assistant
1476
PR
Other
Enumeration date
09/12/2022
Last updated
01/03/2024
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