Provider Demographics
NPI:1699387506
Name:VIRTUOSO, MICHAEL JOSEPH (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:VIRTUOSO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10510 SOUTHERN HIGHLANDS PKWY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-4373
Mailing Address - Country:US
Mailing Address - Phone:702-260-1992
Mailing Address - Fax:702-260-0595
Practice Address - Street 1:10510 SOUTHERN HIGHLANDS PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-4373
Practice Address - Country:US
Practice Address - Phone:702-260-1992
Practice Address - Fax:702-260-0595
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS023896183500000X
NV19921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist