Healthcare Provider Details

I. General information

NPI: 1295751600
Provider Name (Legal Business Name): ANTHONY CHARLES RUGGEROLI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9159 W FLAMINGO RD STE 100
LAS VEGAS NV
89147-6454
US

IV. Provider business mailing address

9159 W FLAMINGO RD STE 100
LAS VEGAS NV
89147-6454
US

V. Phone/Fax

Practice location:
  • Phone: 702-307-7700
  • Fax: 702-307-7942
Mailing address:
  • Phone: 702-307-7700
  • Fax: 702-307-7942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number8127
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number8127
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: