Provider Demographics
NPI:1992528160
Name:BONDARS, MARIS
Entity type:Individual
Prefix:
First Name:MARIS
Middle Name:
Last Name:BONDARS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 W HACIENDA AVE UNIT 2081
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-0326
Mailing Address - Country:US
Mailing Address - Phone:786-851-4923
Mailing Address - Fax:
Practice Address - Street 1:5055 W HACIENDA AVE UNIT 2081
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-0326
Practice Address - Country:US
Practice Address - Phone:786-851-4923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant