Provider Demographics
NPI:1275181349
Name:VILLASFER, RIZALDY
Entity Type:Individual
Prefix:
First Name:RIZALDY
Middle Name:
Last Name:VILLASFER
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 1:8930 SANIBEL SHORE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6566
Mailing Address - Country:US
Mailing Address - Phone:702-606-3989
Mailing Address - Fax:
Practice Address - Street 1:8930 SANIBEL SHORE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6566
Practice Address - Country:US
Practice Address - Phone:702-606-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant