Provider Demographics
NPI:1518570480
Name:VEGAS VALLEY EYE AND VISION
Entity Type:Organization
Organization Name:VEGAS VALLEY EYE AND VISION
Other - Org Name:VEGAS VALLEY EYE AND VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:SORGENTONI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:725-867-6593
Mailing Address - Street 1:3934 SANGRE DE CRISTO AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-0558
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3200 LAS VEGAS BLVD S STE 1620
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-0739
Practice Address - Country:US
Practice Address - Phone:725-867-6593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty