Provider Demographics
NPI:1598464380
Name:OROZCO BERMUDEZ, ELIZABETH (LVN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:OROZCO BERMUDEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-3013
Mailing Address - Country:US
Mailing Address - Phone:760-482-0864
Mailing Address - Fax:
Practice Address - Street 1:200 S 5TH ST
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-3013
Practice Address - Country:US
Practice Address - Phone:760-482-0864
Practice Address - Fax:760-482-9185
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA725318164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse