Av Resuello Medical Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

8004 Issued in NV

Legal business name

AV RESUELLO MEDICAL CORPORATION

Doing business as

Av Resuello Medical Group

Practice address

1300 S Maryland Pkwy
Las Vegas, NV 89104-3310

Phone

(702) 385-4929

Fax

(702) 385-4457

NPI assigned

Feb 25, 2013

Last updated

Feb 25, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Adelaida Valerio Resuello, MDNPI 1194786582

Title

President

Phone

(702) 385-4929

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• AV RESUELLO MEDICAL GROUP Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adelaida Valerio Resuello, MD

  • Pediatrics Physician
  • Las Vegas, NV
  • NPI 1194786582

  Internal Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1184964306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891043310",
            "telephone_number": "702-385-4929",
            "fax_number": "702-385-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891043310",
            "telephone_number": "702-385-4929",
            "fax_number": "702-385-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AV RESUELLO MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-25",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "RESUELLO",
        "authorized_official_first_name": "ADELAIDA",
        "authorized_official_middle_name": "VALERIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-385-4929",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "8004",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "8004",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002019195",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AV RESUELLO MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.