Provider Demographics
NPI:1558711267
Name:CASARES-CUELLAR, ELINA
Entity Type:Individual
Prefix:
First Name:ELINA
Middle Name:
Last Name:CASARES-CUELLAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELINA
Other - Middle Name:
Other - Last Name:CASARES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2309 DEMETRIUS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-1424
Mailing Address - Country:US
Mailing Address - Phone:702-572-1877
Mailing Address - Fax:
Practice Address - Street 1:2309 DEMETRIUS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-1424
Practice Address - Country:US
Practice Address - Phone:702-572-1877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner