Provider Demographics
NPI:1629347885
Name:TOMAS, ELENA SUAREZ
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:SUAREZ
Last Name:TOMAS
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 1:1528 LADY BRYAN LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-1719
Mailing Address - Country:US
Mailing Address - Phone:702-531-2739
Mailing Address - Fax:
Practice Address - Street 1:5319 STAMPA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6853
Practice Address - Country:US
Practice Address - Phone:702-253-5627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-17
Last Update Date:2011-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator