Provider Demographics
NPI:1992467815
Name:ARES-GATTORNO, ALEXEIS (MBA)
Entity Type:Individual
Prefix:
First Name:ALEXEIS
Middle Name:
Last Name:ARES-GATTORNO
Suffix:
Gender:M
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 INCLINE VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-0693
Mailing Address - Country:US
Mailing Address - Phone:725-400-6444
Mailing Address - Fax:
Practice Address - Street 1:5130 S PECOS RD UNIT 1A1
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-1201
Practice Address - Country:US
Practice Address - Phone:725-205-3203
Practice Address - Fax:725-205-1861
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor