Provider Demographics
NPI:1891534897
Name:RAMOS-MACATO, ALEXZZA SHARYNE
Entity type:Individual
Prefix:
First Name:ALEXZZA
Middle Name:SHARYNE
Last Name:RAMOS-MACATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXZZA
Other - Middle Name:SHARYNE
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6860 PAINTED MORNING AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-3645
Mailing Address - Country:US
Mailing Address - Phone:702-417-1073
Mailing Address - Fax:
Practice Address - Street 1:4060 N MARTIN L KING BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-3212
Practice Address - Country:US
Practice Address - Phone:702-380-1712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA3044363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant