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NPI Code Detail

MEDICARE: MR. ANTHONY DARNELL ROLAND SR.

MEDICARE: MR. ANTHONY DARNELL ROLAND SR.
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
1225400000XRehabilitation PractitionerNV20091553153NV

General Provider Information

NPI Number : 1518251305
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANTHONY DARNELL ROLAND SR.
Provider Business Mailing Address
First Line : 725 S HUALAPAI WAY APT 2115
Second Line :
City : LAS VEGAS
State : NV
Zip : 89145-8843
Country : US
Telephone Number : 714-851-0957
Fax Number :
Provider Business Practice Location Address
First Line : 2445 FIRE MESA ST STE 190
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-9015
Country : US
Telephone Number : 702-212-3008
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2011
Last Update Date : 06/08/2011

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