MEDICARE: FERTILITY CENTER OF LAS VEGAS LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LX0001X	Obstetrics & Gynecology Nurse Practitioner
2	207VE0102X	Reproductive Endocrinology Physician

General Provider Information

NPI Number	:	1063694651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FERTILITY CENTER OF LAS VEGAS LLP

Provider Business Mailing Address
First Line	:	8851 W SAHARA AVE STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5890
Country	:	US
Telephone Number	:	702-254-1777
Fax Number	:	702-228-2678

Provider Business Practice Location Address
First Line	:	8851 W SAHARA AVE STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5890
Country	:	US
Telephone Number	:	702-254-1777
Fax Number	:	702-228-2678

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	BRUCE S SHAPIRO
Credential	:	MD
Telephone Number	:	702-254-1777

Provider Enumeration Date	:	12/05/2007
Last Update Date	:	12/05/2007

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Directions to “FERTILITY CENTER OF LAS VEGAS LLP ” Practice Location

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