Provider Demographics
NPI:1831940899
Name:ROSALES LARA, ROCIO
Entity type:Individual
Prefix:
First Name:ROCIO
Middle Name:
Last Name:ROSALES LARA
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 1:4320 JADESTONE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108
Mailing Address - Country:US
Mailing Address - Phone:702-810-2781
Mailing Address - Fax:
Practice Address - Street 1:2810 W. CHARLESTON BLVD.
Practice Address - Street 2:SUITE #83
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:702-331-4969
Practice Address - Fax:202-202-6361
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant