MEDICARE: CARDIOLOGY ASSOC. 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	207RC0000X	Cardiovascular Disease Physician		NV

General Provider Information

NPI Number	:	1730186388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOLOGY ASSOC. OF NEVADA

Provider Business Mailing Address
First Line	:	1090 E DESERT INN RD
Second Line	:	# H100
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2824
Country	:	US
Telephone Number	:	702-765-5720
Fax Number	:	702-765-5826

Provider Business Practice Location Address
First Line	:	1090 E DESERT INN RD
Second Line	:	# H100
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2824
Country	:	US
Telephone Number	:	702-765-5720
Fax Number	:	702-765-5826

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. CHERYL WINN
Credential	:
Telephone Number	:	702-765-5718

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	07/21/2022

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