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General NPI Number Information
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NPI Number | 1407383904
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Entity Type | Individual
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Provider Name | ROMMEL DE VERA D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/15/2017
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 5320 S RAINBOW BLVD STE 302
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City | LAS VEGAS
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State | NV
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Zip | 89118-1896
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Country | US
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Telephone | 702-867-9339
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Fax | 702-640-5898
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Provider Business Mailing Address
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Address Line | 2345 E PRATER WAY STE 207
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City | SPARKS
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State | NV
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Zip | 89434-9634
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Country | US
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Telephone | 702-867-9339
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Fax | 702-640-5898
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO2659
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License Number State | NV
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