Provider Demographics
NPI:1447211123
Name:MUYOT, MARIA ROLIZA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ROLIZA
Last Name:MUYOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12281 BLUEBIRD CANYON PL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138
Mailing Address - Country:US
Mailing Address - Phone:702-396-9858
Mailing Address - Fax:
Practice Address - Street 1:7180 CASCADE VALLEY CT
Practice Address - Street 2:SUITE 180
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0449
Practice Address - Country:US
Practice Address - Phone:702-641-2150
Practice Address - Fax:702-228-1043
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9822208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018634Medicaid