Most Relevant Information
Provider Data
| NPI Number: | 1003674227 |
| Provider Name: | MARIO NARDO FRAGOSO |
| Entity Type: | Individual |
| Taxonomy Code: | 372500000X |
| Specialty: | Chore Provider |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/12/2024 |
| Last Updated: | 03/12/2024 |
Provider Practice Location
60 N PECOS RD
LAS VEGAS
NV
891014839
Practice Location Phone/Fax
| Phone: | 7027336300 |
| Fax: |
Provider Mailing Location
60 N PECOS RD
LAS VEGAS
NV
891014839
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |