Individual
ANTONIO RUIZ PELFORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1951 STELLA LAKE ST SUITE 36, LAS VEGAS, NV 89106
(702) 595-8309
Mailing address
3816 APACHE LN, LAS VEGAS, NV 89107
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2105293089
—
NV
Enumeration date
11/27/2018
Last updated
11/27/2018
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