Provider Demographics
NPI:1376845784
Name:BADIOLA, DOLORA RAMOS
Entity Type:Individual
Prefix:
First Name:DOLORA
Middle Name:RAMOS
Last Name:BADIOLA
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 1:43 DROPLET ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-5041
Mailing Address - Country:US
Mailing Address - Phone:702-839-8775
Mailing Address - Fax:
Practice Address - Street 1:43 DROPLET ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5041
Practice Address - Country:US
Practice Address - Phone:702-839-8775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor