Organization
SILVER STATE CARDIOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE AQUINO M.D. (OWNER/OFFICER)
(702) 270-2721
Entity
Organization
Contact information
Practice address
4200 W CHARLESTON BLVD BLDG A, LAS VEGAS, NV 89102-1625
(702) 683-7876
(702) 331-5764
Mailing address
4200 W CHARLESTON BLVD BLDG A, LAS VEGAS, NV 89102-1625
(702) 683-7876
(702) 331-5764
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
9278
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DR3800
RR MEDICARE PTAN
—
01
—
EN355A
MEDICARE PTAN
NV
Enumeration date
09/24/2010
Last updated
11/19/2012
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