Healthcare Provider Details

I. General information

NPI: 1962401893
Provider Name (Legal Business Name): NICHOLAS FRANCIS FIORE M.D., P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

653 N TOWN CENTER DR SUITE 507
LAS VEGAS NV
89144-0514
US

IV. Provider business mailing address

653 N. TOWN CENTER DR SUITE 507
LAS VEGAS NV
89144
US

V. Phone/Fax

Practice location:
  • Phone: 702-233-8101
  • Fax: 702-242-0726
Mailing address:
  • Phone: 702-233-8101
  • Fax: 702-242-0726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number8647
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: