Provider Demographics
NPI:1801478805
Name:PEREZ MENDEZ, ELDA DE JESUS
Entity type:Individual
Prefix:
First Name:ELDA
Middle Name:DE JESUS
Last Name:PEREZ MENDEZ
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 1:2816 WHISTLING VINES ST.
Mailing Address - Street 2:
Mailing Address - City:LOS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106
Mailing Address - Country:US
Mailing Address - Phone:702-904-5758
Mailing Address - Fax:702-915-7384
Practice Address - Street 1:4525 S SANDHILL RD UNIT 112
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121
Practice Address - Country:US
Practice Address - Phone:702-954-4087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care