Provider Demographics
NPI:1205458015
Name:KANDELL, RONALD ERIC (EMHT)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:ERIC
Last Name:KANDELL
Suffix:
Gender:M
Credentials:EMHT
Other - Prefix:
Other - First Name:ERIC
Other - Middle Name:RONALD
Other - Last Name:KANDELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EMHT
Mailing Address - Street 1:1771 E FLAMINGO RD STE 215B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5154
Mailing Address - Country:US
Mailing Address - Phone:702-834-9260
Mailing Address - Fax:702-337-2027
Practice Address - Street 1:1771 E FLAMINGO RD STE 215B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5154
Practice Address - Country:US
Practice Address - Phone:702-834-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health