Provider Demographics
NPI:1639832173
Name:AGUAYO MORALES, MA. DEL ROSARIO
Entity Type:Individual
Prefix:
First Name:MA. DEL
Middle Name:ROSARIO
Last Name:AGUAYO MORALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MA. DEL
Other - Middle Name:ROSARIO
Other - Last Name:AGUAYO MORALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2415 REYNOLDS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2415 REYNOLDS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030
Practice Address - Country:US
Practice Address - Phone:702-722-1229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant