Provider Demographics
NPI:1932852597
Name:GONZALEZ, BENISIA SANCHEZ
Entity Type:Individual
Prefix:
First Name:BENISIA
Middle Name:SANCHEZ
Last Name:GONZALEZ
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 1:2770 S MARYLAND PKWY STE AAND213B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-1554
Mailing Address - Country:US
Mailing Address - Phone:702-331-0100
Mailing Address - Fax:
Practice Address - Street 1:4470 VEGAS VALLEY DR SPC 128
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-1922
Practice Address - Country:US
Practice Address - Phone:702-521-9738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant