Provider Demographics
NPI:1841799244
Name:BARZONI, RONALD JOSEPH III
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:JOSEPH
Last Name:BARZONI
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7023 TIDELANDS PARK CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-7132
Mailing Address - Country:US
Mailing Address - Phone:702-613-7370
Mailing Address - Fax:
Practice Address - Street 1:2820 W CHARLESTON BLVD STE 21
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1930
Practice Address - Country:US
Practice Address - Phone:702-413-6011
Practice Address - Fax:702-988-8780
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV374U00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty