Healthcare Provider Details

I. General information

NPI: 1750953089
Provider Name (Legal Business Name): VEGAS VISITING PHYSICIANS ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2021
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5495 S RAINBOW BLVD STE 202
LAS VEGAS NV
89118-1873
US

IV. Provider business mailing address

47 E AGATE AVE UNIT 205
LAS VEGAS NV
89123-6060
US

V. Phone/Fax

Practice location:
  • Phone: 775-990-8441
  • Fax:
Mailing address:
  • Phone: 702-556-3160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY A. SUAREZ
Title or Position: PRESIDENT
Credential: PA
Phone: 702-556-3160