Provider Demographics
NPI:1326107954
Name:PRADO, LILIA (DO)
Entity type:Individual
Prefix:
First Name:LILIA
Middle Name:
Last Name:PRADO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LILIA
Other - Middle Name:
Other - Last Name:PRADO-GOBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:321 N NELLIS BLVD STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5416
Practice Address - Country:US
Practice Address - Phone:702-438-4003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO2678207Q00000X
CA20A5538207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1326107954Medicaid
NVDO2678OtherSTATE LICENSE