MEDICARE: VEGAS VALLEY EYE AND VISION

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1518570480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VEGAS VALLEY EYE AND VISION

Provider Business Mailing Address
First Line	:	3460 S MARYLAND PKWY # 180
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3036
Country	:	US
Telephone Number	:	725-735-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	3460 S MARYLAND PKWY # 180
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3036
Country	:	US
Telephone Number	:	725-735-8400
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. VINCENT SORGENTONI
Credential	:	OD
Telephone Number	:	725-735-8400

Provider Enumeration Date	:	08/28/2020
Last Update Date	:	11/20/2024

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Directions to “VEGAS VALLEY EYE AND VISION ” Practice Location

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