Provider Demographics
NPI:1669015236
Name:PEREZ RUIZ, MAGALY
Entity Type:Individual
Prefix:
First Name:MAGALY
Middle Name:
Last Name:PEREZ RUIZ
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 1:4150 S HUALAPAI WAY UNIT 3088
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8770
Mailing Address - Country:US
Mailing Address - Phone:702-665-2076
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?:Yes
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant