Provider Demographics
NPI:1346871456
Name:RUEDA PADRON, LILIA TANIA
Entity Type:Individual
Prefix:
First Name:LILIA
Middle Name:TANIA
Last Name:RUEDA PADRON
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 1:2433 SWIFTON CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-5075
Mailing Address - Country:US
Mailing Address - Phone:702-587-3592
Mailing Address - Fax:
Practice Address - Street 1:2433 SWIFTON CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-5075
Practice Address - Country:US
Practice Address - Phone:702-587-3592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant