Provider Demographics
NPI:1407802598
Name:FILIPPOS S. DIAMANTIS RPT LTD
Entity Type:Organization
Organization Name:FILIPPOS S. DIAMANTIS RPT LTD
Other - Org Name:DIAMANTIS PHYSICAL THERAPIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ P.T.
Authorized Official - Prefix:
Authorized Official - First Name:FILIPPOS
Authorized Official - Middle Name:S
Authorized Official - Last Name:DIAMANTIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:702-384-5855
Mailing Address - Street 1:2601 W CHARLESTON BLVD
Mailing Address - Street 2:STE # B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2107
Mailing Address - Country:US
Mailing Address - Phone:702-384-5855
Mailing Address - Fax:702-384-7594
Practice Address - Street 1:2601 W CHARLESTON BLVD
Practice Address - Street 2:STE # B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2107
Practice Address - Country:US
Practice Address - Phone:702-384-5855
Practice Address - Fax:702-384-7594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV97119208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty