1265231872 NPI number — SERENITYMED SOLUTIONS LLC

Table of content: DR. MAURICE ASHLEY SAMPEDRO D.C. (NPI 1942289525)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265231872 NPI number — SERENITYMED SOLUTIONS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SERENITYMED SOLUTIONS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265231872
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4525 S SANDHILL RD STE 119
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89121-5956
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
725-550-8084
Provider Business Mailing Address Fax Number:
725-550-8084

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4525 S SANDHILL RD STE 119
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89121-5956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
725-550-8084
Provider Business Practice Location Address Fax Number:
725-550-8084
Provider Enumeration Date:
03/08/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LINARES ANGEL
Authorized Official First Name:
ANAY
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
725-550-8084

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP3300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QX0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)