Provider Demographics
NPI:1083194922
Name:MATHIAS, FROLINDA P,
Entity Type:Individual
Prefix:
First Name:FROLINDA
Middle Name:P,
Last Name:MATHIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 ARVILLE ST APT 344
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3728
Mailing Address - Country:US
Mailing Address - Phone:702-972-2013
Mailing Address - Fax:
Practice Address - Street 1:5701 AVENIDA TAMPICO
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-4161
Practice Address - Country:US
Practice Address - Phone:702-370-1730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant