IndividualActive
Agatha Formoso, MD
NPI 1124657036 · Pediatrics Physician · Las Vegas, NV
Provider details
- NPI number
- 1124657036
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- 24172 (NV)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Student, Health Care
Practice location
2650 N Tenaya Way # 308
Las Vegas, NV 89128-1102
Phone: (702) 870-2099
Fax: (702) 869-5347
Approximate (ZIP-level) locationGet directions
Mailing address
6355 S Buffalo Dr Fl 3
Las Vegas, NV 89113-2133
Additional practice locations (1)
- 1919 E Thomas RdPhoenix, AZ 85016-7710Phone: (602) 933-0945
Registry dates
- Enumerated
- 2020-04-02
- Last updated
- 2023-11-16
- Certified
- 2023-11-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.