Provider Demographics
NPI:1205308350
Name:AGUADO, SONIA
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:AGUADO
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 1:4550 W OAKEY BLVD STE 111-O
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1581
Mailing Address - Country:US
Mailing Address - Phone:702-583-2825
Mailing Address - Fax:702-938-5896
Practice Address - Street 1:2192 S NELLIS BLVD APT 311
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-6249
Practice Address - Country:US
Practice Address - Phone:702-420-0287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant