Provider Demographics
NPI:1275097099
Name:SARDUY, ALEJANDRO MIGUEL
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:MIGUEL
Last Name:SARDUY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4480 SIRIUS AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-7327
Mailing Address - Country:US
Mailing Address - Phone:786-420-9803
Mailing Address - Fax:
Practice Address - Street 1:8855 W ARBY AVE APT 3005
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-2212
Practice Address - Country:US
Practice Address - Phone:786-420-9803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant