Healthcare Provider Details

I. General information

NPI: 1558411207
Provider Name (Legal Business Name): SILVIA ADA BEVILACQUA MCBRIDE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 SIENA HEIGHTS DR
HENDERSON NV
89052-4153
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 702-243-4603
  • Fax: 702-877-5341
Mailing address:
  • Phone: 702-243-4603
  • Fax: 702-877-5341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME88442
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number21874
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number17441
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: