Medicotek Inc

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

MEDICOTEK INC

Practice address

6859 S Eastern Ave Ste 103
Las Vegas, NV 89119-0003

Phone

(702) 778-4838

NPI assigned

Aug 9, 2021

Organization subpart

Yes

Parent organization

MEDICOTEK INCAs reported in NPPES

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

Authorized official

Name

Marivic Luna Banal

Title

Director

Phone

(702) 778-4838

Specialties & licenses 4

Addresses

Other names 1

• OPTIMA HEALTHCARE Doing business as

Part of

Medicotek Inc

Locations

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1790450104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6859 S EASTERN AVE STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891190003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6859 S EASTERN AVE STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891190003",
            "telephone_number": "702-778-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICOTEK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICOTEK INC",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "BANAL",
        "authorized_official_first_name": "MARIVIC",
        "authorized_official_middle_name": "LUNA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-778-4838"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OPTIMA HEALTHCARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OPTIMA HEALTHCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medical Ultrasound Imaging LLC
• Medication Assisted Treatment Las Vegas
• Felicia Medicina, RN
• Medicloud Care LLC
• Medicore Alpha LLC
• Medics on the Move LLC
• Noemi Medina Cardenas
• Amalia Medina de Armenta
• Teresa Medina de Olmos
• Norelis Medina Lao

• Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.