Healthcare Provider Details

I. General information

NPI: 1255866323
Provider Name (Legal Business Name): KEITH LAURENCE APOSTOL CORNEL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2017
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 SAINT ROSE PKWY STE 110
HENDERSON NV
89052-4812
US

IV. Provider business mailing address

9950 W CHEYENNE AVE STE 110
LAS VEGAS NV
89129-7700
US

V. Phone/Fax

Practice location:
  • Phone: 702-805-5678
  • Fax: 702-268-7605
Mailing address:
  • Phone: 702-805-5678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberDO3573
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: