Provider Demographics
NPI:1477061695
Name:GONZALEZ-ALVAREZ, MAILYN
Entity Type:Individual
Prefix:
First Name:MAILYN
Middle Name:
Last Name:GONZALEZ-ALVAREZ
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 1:7605 ROCKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7929
Mailing Address - Country:US
Mailing Address - Phone:702-637-8251
Mailing Address - Fax:
Practice Address - Street 1:7605 ROCKFIELD DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7929
Practice Address - Country:US
Practice Address - Phone:702-637-8251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant