Provider Demographics
NPI:1306275128
Name:RODRIGUEZ-ORNELAS, MARIBEL
Entity type:Individual
Prefix:MS
First Name:MARIBEL
Middle Name:
Last Name:RODRIGUEZ-ORNELAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 BUCHANAN BLVD
Mailing Address - Street 2:#115-214
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-2130
Mailing Address - Country:US
Mailing Address - Phone:915-474-2758
Mailing Address - Fax:
Practice Address - Street 1:13016 BIRDSVIEW CIR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2786
Practice Address - Country:US
Practice Address - Phone:915-474-2758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider