Provider Demographics
NPI:1023811817
Name:MEDICAL SOLUTIONS CENTER LLC
Entity type:Organization
Organization Name:MEDICAL SOLUTIONS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ODELAISY
Authorized Official - Middle Name:
Authorized Official - Last Name:AREVALO BLANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-591-3243
Mailing Address - Street 1:4521 E BONANZA RD APT 258
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-3395
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4521 E BONANZA RD APT 258
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-3395
Practice Address - Country:US
Practice Address - Phone:702-591-3243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service