MEDICARE: CHARLES RUGGEROLI MD

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	207RC0000X	Cardiovascular Disease Physician	9343	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	V33578	OTHER	NV	MEDICARE ID

Other Identifiers

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

General Provider Information

NPI Number	:	1518907401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES RUGGEROLI MD

Provider Business Mailing Address
First Line	:	7020 SMOKE RANCH RD STE 150
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-3111
Country	:	US
Telephone Number	:	702-258-1601
Fax Number	:	702-870-1995

Provider Business Practice Location Address
First Line	:	7020 SMOKE RANCH RD STE 150
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-3111
Country	:	US
Telephone Number	:	702-258-1601
Fax Number	:	702-870-1995

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	08/29/2025

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Directions to “ CHARLES RUGGEROLI MD” Practice Location

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