Provider Demographics
NPI:1942007646
Name:OSORIO MONTOYA, ELIA DEL ROSARIO
Entity type:Individual
Prefix:
First Name:ELIA
Middle Name:DEL ROSARIO
Last Name:OSORIO MONTOYA
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 1:3725 S. EASTERN AVE.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119
Mailing Address - Country:US
Mailing Address - Phone:702-331-6200
Mailing Address - Fax:
Practice Address - Street 1:3725 S. EASTERN AVE.
Practice Address - Street 2:SUITE 1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119
Practice Address - Country:US
Practice Address - Phone:702-331-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant