Provider Demographics
NPI:1467224170
Name:ELACIO, RODOLFO (RN)
Entity Type:Individual
Prefix:
First Name:RODOLFO
Middle Name:
Last Name:ELACIO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2821 W HORIZON RIDGE PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4429
Mailing Address - Country:US
Mailing Address - Phone:702-893-3333
Mailing Address - Fax:702-413-7775
Practice Address - Street 1:7250 PEAK DR STE 118
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-9028
Practice Address - Country:US
Practice Address - Phone:702-846-2100
Practice Address - Fax:702-665-5170
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV835859163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse