Sta Maria Pediatric Clinic LLC

NPI #1104244011 in Las Vegas, Nevada

Provider Information

NPI Number: 1104244011
Entity Type: Organization
Organization Name: Sta Maria Pediatric Clinic LLC
Primary Specialty: Pediatrics
Enumeration Date: Mar 29, 2014
Last Updated: Apr 8, 2014

Practice Location

Address: 730 N EASTERN AVE
Address 2: STE 100
City: Las Vegas
State: Nevada
ZIP Code: 89101-2885
Phone: (702) 388-4428

Authorized Official

Name: TERESITA LU MELOCOTON, MD
Title: MANAGER
Phone: (702) 388-4428

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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