Julio Angel Alexander Ambriz, MD

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Las Vegas, NV

NPI 1689433112 · NPPES record last updated Mar 18, 2024

Key facts

NPI
1689433112
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1701 W Charleston Blvd Ste 670
Las Vegas, NV 89102-2343
Phone
(702) 701-3839
NPI assigned
Mar 18, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240826001640 NV Order and Referring Only - Pediatric Medicine
Practitioner - Pediatric Medicine
8224577085

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1701 W Charleston Blvd Ste 670
Las Vegas, NV 89102-2343

Mailing address

1701 W Charleston Blvd Ste 670
Las Vegas, NV 89102-2343
Phone (702) 701-3839

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Student in an Organized Health Care Education/Training Program in Nevada

Sources for this page

Verify at the official NPI Registry.