Provider Demographics
NPI:1891580304
Name:MATURIN, LUCIA
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:MATURIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:976 GRAND CERRITOS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-4675
Mailing Address - Country:US
Mailing Address - Phone:702-808-2992
Mailing Address - Fax:
Practice Address - Street 1:7155 S RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3266
Practice Address - Country:US
Practice Address - Phone:702-808-2992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist