Provider Demographics
NPI:1396823928
Name:SOUTHWEST LAS VEGAS SLEEP CENTER
Entity Type:Organization
Organization Name:SOUTHWEST LAS VEGAS SLEEP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:DIMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-285-9598
Mailing Address - Street 1:2641 BOX CANYON DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128
Mailing Address - Country:US
Mailing Address - Phone:440-285-9598
Mailing Address - Fax:
Practice Address - Street 1:13221 RAVENNA RD
Practice Address - Street 2:SUITE 13
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-9047
Practice Address - Country:US
Practice Address - Phone:440-285-9598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty