Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Mario Oliver Tablante Godoy, APRNNP-C

Individual provider Family Nurse Practitioner · NPI 1275822611

Mr. Mario Oliver Tablante Godoy, APRNNP-C is a Nurse Practitioner in Las Vegas, Nevada. Qualified in 1995, 31 years ago. Practices with Doyne Medical Clinic Inc, a 2-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Nevada.

Years since qualifying
31
Licensed in
NV
In the registry since
2011
Specialties on file
3
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Practice location Address checks out

1706 W Bonanza Rd
Las Vegas, NV 89106-4704
Phone: (702) 631-6860
Fax: (702) 631-6864
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence APRN001258 (NV)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence APRN001258 (NV)
Registered Nurse Taxonomy 163W00000X · Licence RN67477 (NV)

Record details

NPI number1275822611
Entity typeIndividual (Type 1)
GenderMale
Credentials APRNNP-C
Sole proprietorNo
NPI enumeratedApril 6, 2011
Last updated in NPPESFebruary 10, 2026
Certification dateFebruary 10, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Doyne Medical Clinic Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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