Provider Demographics
NPI:1720013006
Name:PLON SPACCAVENTO & ASSOCIATES, LTD
Entity Type:Organization
Organization Name:PLON SPACCAVENTO & ASSOCIATES, LTD
Other - Org Name:ADVANCED HEART CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:SPACCAVENTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-796-4278
Mailing Address - Street 1:4275 BURNHAM AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5400
Mailing Address - Country:US
Mailing Address - Phone:702-734-0808
Mailing Address - Fax:702-734-2650
Practice Address - Street 1:4275 BURNHAM AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5488
Practice Address - Country:US
Practice Address - Phone:702-734-0808
Practice Address - Fax:702-734-2650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1000117650207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002002318Medicaid
AZ001206Medicaid
NVVWJBKFOtherPTAN
C96448Medicare UPIN