Healthcare Provider Details

I. General information

NPI: 1396823928
Provider Name (Legal Business Name): SOUTHWEST LAS VEGAS SLEEP CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13221 RAVENNA RD SUITE 13
CHARDON OH
44024-9047
US

IV. Provider business mailing address

2641 BOX CANYON DRIVE SUITE B
LAS VEGAS NV
89128
US

V. Phone/Fax

Practice location:
  • Phone: 440-285-9598
  • Fax:
Mailing address:
  • Phone: 440-285-9598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY F DIMARCO
Title or Position: CO-DIRECTOR
Credential: M.D.
Phone: 440-285-9598