Provider Demographics
NPI:1275015430
Name:VALLADARES, MARITZA S
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:S
Last Name:VALLADARES
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 1:9725 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89143-1224
Mailing Address - Country:US
Mailing Address - Phone:702-588-3903
Mailing Address - Fax:
Practice Address - Street 1:3329 STURBRIDGE CIR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6236
Practice Address - Country:US
Practice Address - Phone:702-588-3903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide