Individual
MITZILENE ANNE ALFONSO TUAZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4475 S EASTERN AVE, LAS VEGAS, NV 89119-7826
(702) 737-1880
(702) 650-2458
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5199
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
157598
FL
207Q00000X
Family Medicine Physician
Primary
16533
NV
207QA0505X
Adult Medicine Physician
157598
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SMA MEDICARE
V114219
NV
Enumeration date
04/23/2013
Last updated
11/19/2024
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