Healthcare Provider Details
I. General information
NPI: 1720013006
Provider Name (Legal Business Name): PLON SPACCAVENTO & ASSOCIATES, LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/12/2006
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7385 S PECOS RD
LAS VEGAS NV
89120-3768
US
IV. Provider business mailing address
7385 S PECOS RD
LAS VEGAS NV
89120-3768
US
V. Phone/Fax
- Phone: 702-796-4278
- Fax: 702-737-9286
- Phone: 702-796-4278
- Fax: 27-379-2867
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | 1000117650 |
| License Number State | NV |
VIII. Authorized Official
Name: DR.
LEO
SPACCAVENTO
Title or Position: PRESIDENT
Credential: MD
Phone: 702-796-4278