MEDICARE: CARDIOVASCULAR CONSULTANTS OF NEVADA

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	207RC0001X	Clinical Cardiac Electrophysiology Physician
2	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225196447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOVASCULAR CONSULTANTS OF NEVADA

Provider Business Mailing Address
First Line	:	2865 SIENA HEIGHTS DR
Second Line	:	SUITE 331-A
City	:	HENDERSON
State	:	NV
Zip	:	89052-4167
Country	:	US
Telephone Number	:	702-731-8224
Fax Number	:	702-990-8738

Provider Business Practice Location Address
First Line	:	2865 SIENA HEIGHTS DR
Second Line	:	SUITE 331-A
City	:	HENDERSON
State	:	NV
Zip	:	89052-4167
Country	:	US
Telephone Number	:	702-731-8224
Fax Number	:	702-990-8738

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	LUANN M FILLION
Credential	:	7026919110
Telephone Number	:	702-691-9110

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	03/30/2012

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Directions to “CARDIOVASCULAR CONSULTANTS OF NEVADA ” Practice Location

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