Provider Demographics
NPI:1487207056
Name:MELGAR, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MELGAR
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 1:5099 NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-7076
Mailing Address - Country:US
Mailing Address - Phone:702-517-2778
Mailing Address - Fax:
Practice Address - Street 1:5099 NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-7076
Practice Address - Country:US
Practice Address - Phone:702-786-9454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant