Individual ProviderAgustin Rivera GonzalezTechnicianNursing Service Related ProvidersPractice Address2770 S Maryland Pkwy, Las Vegas, NV 89109-1554(702) 463-7779PECOS EnrollmentBased on the most recent information from CMS, provider Agustin Rivera Gonzalez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1083230452Provider TypeIndividualFull NameRivera Gonzalez, AgustinGenderMaleSole ProprietorYesEnumeration Date6/22/2020Last Updated6/22/2020Contact InformationPractice LocationPractice Address2770 S Maryland Pkwy, Las Vegas, NV 89109-1554Phone(702) 463-7779FaxUnlisted FaxMailing LocationMailing Address2770 S Maryland Pkwy, Las Vegas, NV 89109-1554Phone(702) 463-7779FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode3747P1801XPrimaryDescriptionTechnicianNursing Service Related ProvidersLicenseUnlisted Issuer