Provider Demographics
NPI:1154078038
Name:FAROL, PERFECTA MARTINEZ
Entity Type:Individual
Prefix:
First Name:PERFECTA
Middle Name:MARTINEZ
Last Name:FAROL
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 1:1489 W WARM SPRINGS RD STE 110
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-7367
Mailing Address - Country:US
Mailing Address - Phone:833-636-8305
Mailing Address - Fax:
Practice Address - Street 1:1489 W WARM SPRINGS RD STE 110
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7367
Practice Address - Country:US
Practice Address - Phone:833-636-8305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant