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Organization

ARVAMA MEDICAL CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALEXEY MARTIN MANSO (OFFICER MANAGER)
(702) 504-6590
Entity
Organization

Contact information

Practice address
4660 S EASTERN AVE STE 205, LAS VEGAS, NV 89119-6139
(702) 504-6590
Mailing address
3543 WINGROVE AVE, LAS VEGAS, NV 89121-3550
(702) 504-6590

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2084P0800X
Psychiatry Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1705319639
NV
Enumeration date
07/28/2025
Last updated
08/19/2025
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