Healthcare Provider Details

I. General information

NPI: 1942926126
Provider Name (Legal Business Name): NEVADA ANESTHESIA CONSORTIUM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1748 W HORIZON RIDGE PKWY
HENDERSON NV
89012-4833
US

IV. Provider business mailing address

1000 N GREEN VALLEY PKWY # 440-532
HENDERSON NV
89074-6170
US

V. Phone/Fax

Practice location:
  • Phone: 702-982-1300
  • Fax: 702-728-5661
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL E FABITO
Title or Position: OWNER
Credential: MD
Phone: 702-556-6943