Healthcare Provider Details

I. General information

NPI: 1558019018
Provider Name (Legal Business Name): GIOVANNI SCOTT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 W OWENS AVE STE 4
LAS VEGAS NV
89106-2452
US

IV. Provider business mailing address

2780 S JONES BLVD STE 221
LAS VEGAS NV
89146-5628
US

V. Phone/Fax

Practice location:
  • Phone: 702-689-8658
  • Fax:
Mailing address:
  • Phone: 832-713-6453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: