Jose Rafael Otero Gollarza, RNFA

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

RN9614513 Issued in FL

Practice address

5281 River Glen Dr Unit 225
Las Vegas, NV 89103-8756

Phone

(702) 936-2635

NPI assigned

Nov 24, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1023728581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5281 RIVER GLEN DR UNIT 225",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891038756",
            "telephone_number": "702-936-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5281 RIVER GLEN DR UNIT 225",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891038756",
            "telephone_number": "702-936-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTERO GOLLARZA",
        "first_name": "JOSE",
        "middle_name": "RAFAEL",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-24",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "NV",
            "license": "22-122",
            "primary": false
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "FL",
            "license": "RN9614513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitsue Otaki
• Maria Esmeralda Otame, LCSW
• Isadoris Otano Gutierrez
• Diana Otano
• Michael Otano
• Rafael Otero Gonzalez
• Sergio Otero Gonzalez
• Jacqueline Otero
• Jaden Otero
• Rosa Otero

• Registered Nurse First Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Registered Nurse First Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.