Provider Demographics
NPI:1609426527
Name:NOVAL ARIAS, IDALMIS DE LA CARIDAD
Entity Type:Individual
Prefix:
First Name:IDALMIS
Middle Name:DE LA CARIDAD
Last Name:NOVAL ARIAS
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 1:6431 W SAHARA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-3064
Mailing Address - Country:US
Mailing Address - Phone:702-871-0002
Mailing Address - Fax:
Practice Address - Street 1:6431 W SAHARA AVE STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-3064
Practice Address - Country:US
Practice Address - Phone:702-871-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0032543698753OtherDL