Provider Demographics
NPI:1528562725
Name:BERUMEN, GABINA
Entity Type:Individual
Prefix:
First Name:GABINA
Middle Name:
Last Name:BERUMEN
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 1:1700 E DESERT INN RD STE 314
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-3207
Mailing Address - Country:US
Mailing Address - Phone:702-839-1088
Mailing Address - Fax:702-650-2800
Practice Address - Street 1:1700 E DESERT INN RD STE 314
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3207
Practice Address - Country:US
Practice Address - Phone:702-839-1088
Practice Address - Fax:702-650-2800
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant