Healthcare Provider Details

I. General information

NPI: 1376836080
Provider Name (Legal Business Name): ALEX DEL ROSARIO MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2011
Last Update Date: 05/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5440 W SAHARA AVE SUITE 202
LAS VEGAS NV
89146-0355
US

IV. Provider business mailing address

5440 W SAHARA AVE SUITE 202
LAS VEGAS NV
89146-0355
US

V. Phone/Fax

Practice location:
  • Phone: 702-380-8200
  • Fax: 702-380-3220
Mailing address:
  • Phone: 702-380-8200
  • Fax: 702-380-3220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number10057
License Number StateNV

VIII. Authorized Official

Name: ALEX DEL ROSARIO
Title or Position: PRESIDENT
Credential: MD
Phone: 702-380-8200