Individual
MR. MARIO OLIVER TABLANTE GODOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN NP-C
Contact information
Practice address
1706 W BONANZA RD, LAS VEGAS, NV 89106-4704
(702) 631-6860
(702) 631-6864
Mailing address
8010 BRADLEY RD, LAS VEGAS, NV 89131-2016
(702) 239-9123
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
APN001258
NV
163W00000X
Registered Nurse
RN67477
NV
363LF0000X
Family Nurse Practitioner
APRN001258
NV
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN001258
NV
Other
Enumeration date
04/06/2011
Last updated
02/10/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us