Individual ProviderAbraham VicenteTechnicianNursing Service Related ProvidersPractice Address2770 S Maryland Pkwy Ste 108b-G, Las Vegas, NV 89109-1554(702) 463-7779(702) 517-4166PECOS EnrollmentBased on the most recent information from CMS, provider Abraham Vicente 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 ID1366910671Provider TypeIndividualFull NameVicente, AbrahamGenderMaleSole ProprietorYesEnumeration Date11/5/2018Last Updated11/5/2018Contact InformationPractice LocationPractice Address2770 S Maryland Pkwy Ste 108b-G, Las Vegas, NV 89109-1554Phone(702) 463-7779FaxUnlisted FaxMailing LocationMailing Address6056 Montana Peak Ave, Las Vegas, NV 89139-7110Phone(702) 517-4166FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode3747P1801XPrimaryDescriptionTechnicianNursing Service Related ProvidersLicenseUnlisted Issuer