MEDICARE: TRINOVEON CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1265084073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINOVEON CORPORATION

Provider Business Mailing Address
First Line	:	2700 LAS VEGAS BLVD S UNIT 4105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-1174
Country	:	US
Telephone Number	:	405-627-4668
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 LAS VEGAS BLVD S UNIT 4105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-1174
Country	:	US
Telephone Number	:	405-627-4668
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT, BUSINESS DEVELOPMEN
Name	:	ELIZABETH ROHLFING
Credential	:
Telephone Number	:	314-550-3590

Provider Enumeration Date	:	07/11/2019
Last Update Date	:	09/02/2020

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