Individual
MELVIN BANZON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6765 W CHARLESTON BLVD STE 110, LAS VEGAS, NV 89146-2001
(702) 852-6633
Mailing address
3095 TARPON DR, LAS VEGAS, NV 89120-1198
(702) 580-3157
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
829626
NV
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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