Provider Demographics
NPI:1255192407
Name:VEGAS VASCULAR MEDICINE, PLLC
Entity type:Organization
Organization Name:VEGAS VASCULAR MEDICINE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEL
Authorized Official - Middle Name:AUDREY
Authorized Official - Last Name:CELESTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-827-2362
Mailing Address - Street 1:851 S RAMPART BLVD STE 155
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-4896
Mailing Address - Country:US
Mailing Address - Phone:877-827-2362
Mailing Address - Fax:877-827-2362
Practice Address - Street 1:851 S RAMPART BLVD STE 155
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-4896
Practice Address - Country:US
Practice Address - Phone:877-827-2362
Practice Address - Fax:877-827-2362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular SpecialistGroup - Single Specialty