Provider Demographics
NPI:1548223670
Name:PARRAVANO, JOSEPH GIUSEPPE (MD, DABR, FRCPC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GIUSEPPE
Last Name:PARRAVANO
Suffix:
Gender:M
Credentials:MD, DABR, FRCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 S MARYLAND PKWY
Mailing Address - Street 2:UNLV-HEALTH PHYSICS -MS 45053037
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89154-9900
Mailing Address - Country:US
Mailing Address - Phone:702-967-0671
Mailing Address - Fax:
Practice Address - Street 1:4505 S MARYLAND PKWY
Practice Address - Street 2:UNLV-HEALTH PHYSICS -MS 45053037
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89154-9900
Practice Address - Country:US
Practice Address - Phone:702-967-0671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV109242085R0202X
CAG720562085R0202X
FL590332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV27-02003Medicaid
NV30WCGVL06Medicare PIN
NVE71298Medicare UPIN