MEDICARE: UMAKANTHAN CARDIOLOGY GROUP PLLC

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	207RI0011X	Interventional Cardiology Physician	D01407	NV

General Provider Information

NPI Number	:	1831490796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UMAKANTHAN CARDIOLOGY GROUP PLLC

Provider Business Mailing Address
First Line	:	98 E LAKE MEAD PKWY
Second Line	:	SUITE # 305
City	:	HENDERSON
State	:	NV
Zip	:	89015-5540
Country	:	US
Telephone Number	:	702-765-5780
Fax Number	:	702-565-4915

Provider Business Practice Location Address
First Line	:	98 E LAKE MEAD PKWY
Second Line	:	SUITE # 305
City	:	HENDERSON
State	:	NV
Zip	:	89015-5540
Country	:	US
Telephone Number	:	702-765-5780
Fax Number	:	702-565-4915

Authorized Official
Title or Position	:	MANAGER
Name	:	ERNESTO M ALVARADO
Credential	:
Telephone Number	:	702-765-5788

Provider Enumeration Date	:	11/09/2010
Last Update Date	:	03/28/2011

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