Provider Demographics
NPI:1871216630
Name:PEREZ, YADIRA D
Entity type:Individual
Prefix:
First Name:YADIRA
Middle Name:D
Last Name:PEREZ
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 1:1650 E SAHARA AVE STE 4A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3495
Mailing Address - Country:US
Mailing Address - Phone:702-769-0584
Mailing Address - Fax:702-836-0972
Practice Address - Street 1:1650 E SAHARA AVE STE 4A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3495
Practice Address - Country:US
Practice Address - Phone:702-769-0584
Practice Address - Fax:702-836-0972
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant