Angel Villavicencio-Tundidor | Las Vegas, NV • PECOS Search

Angel Villavicencio-Tundidor

Technician

Nursing Service Related Providers

2770 S Maryland Pkwy Ste 108b-G, Las Vegas, NV 89109-1554

PECOS Enrollment

Based on the most recent information from CMS, provider Angel Villavicencio-Tundidor does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1306314810
Provider Type
Individual
Full Name
Villavicencio-Tundidor, Angel
Gender
Male

Sole Proprietor
Yes
Enumeration Date
11/2/2018
Last Updated
11/2/2018

Contact Information

Practice Location

2770 S Maryland Pkwy Ste 108b-G, Las Vegas, NV 89109-1554

Unlisted Fax

Mailing Location

8121 Dartmoor Ave, Las Vegas, NV 89129-2152

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 3747P1801X Primary	Description Technician Nursing Service Related Providers	License Unlisted Issuer