Provider Demographics
NPI:1477145563
Name:MONTESINOS, ANGIE (CERTIFIED MA)
Entity Type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:MONTESINOS
Suffix:
Gender:F
Credentials:CERTIFIED MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 E FLAMINGO RD STE 311
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5067
Mailing Address - Country:US
Mailing Address - Phone:725-204-7591
Mailing Address - Fax:702-920-8493
Practice Address - Street 1:3430 E FLAMINGO RD STE 311
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5067
Practice Address - Country:US
Practice Address - Phone:725-204-7591
Practice Address - Fax:702-920-8493
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other