DR. Agatha Matsos Formoso, MD

NPI #1124657036 in Las Vegas, Nevada

Provider Information

NPI Number: 1124657036
Entity Type: Individual
Name: DR. Agatha Matsos Formoso, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pediatrics
Credential: MD
Enumeration Date: Apr 2, 2020
Last Updated: Nov 16, 2023

Practice Location

Address: 2650 N TENAYA WAY # 308
City: Las Vegas
State: Nevada
ZIP Code: 89128-1102
Phone: (702) 870-2099

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary
Student in an Organized Health Care Education/Training Program	390200000X

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