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NPI Code Detail

MEDICARE: MRS. GINA NICOLE VENDITTI P.A.

MEDICARE: MRS. GINA NICOLE VENDITTI P.A.
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
1363A00000XPhysician AssistantPA9102437FL
2363AM0700XMedical Physician AssistantPA 1224NV

General Provider Information

NPI Number : 1477579829
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GINA NICOLE VENDITTI P.A.
Provider Business Mailing Address
First Line : 3758 LAS VEGAS BLVD S
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-4132
Country : US
Telephone Number : 702-262-9028
Fax Number : 702-736-3921
Provider Business Practice Location Address
First Line : 3758 LAS VEGAS BLVD S
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-4132
Country : US
Telephone Number : 702-262-9028
Fax Number : 702-736-3921
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 09/07/2010

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Directions to “ MRS. GINA NICOLE VENDITTI P.A.” Practice Location

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