Provider Demographics
NPI:1275103483
Name:BELTRAN, VITTORIO (DPT)
Entity Type:Individual
Prefix:DR
First Name:VITTORIO
Middle Name:
Last Name:BELTRAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2980 S JONES BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5657
Mailing Address - Country:US
Mailing Address - Phone:708-487-5511
Mailing Address - Fax:
Practice Address - Street 1:2980 S JONES BLVD STE C
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5657
Practice Address - Country:US
Practice Address - Phone:702-487-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4197208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation