Candice D Fortunato MD PLLC
Hospitalist in Las Vegas, NV. Organization (NPI-2).
NPI number1831521228
StatusActive
Last updated in NPPESAug 7, 2013
Details
- NPI
- 1831521228
- Entity type
- Organization (NPI-2)
- Legal business name
- Candice D Fortunato MD PLLC
- Organization subpart
- No
- Enumeration date
- Aug 7, 2013
- Last updated
- Aug 7, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208M00000X | Hospitalist | – | – | Yes |
| 207R00000X | Internal Medicine | – | – | |
| 208000000X | Pediatrics | – | – |
Practice location
500 N Rainbow Blvd Ste 300Las Vegas, NV 89107-1061
Phone 702-450-1717 · Fax 702-941-6740
Mailing address
500 N Rainbow Blvd Ste 300Las Vegas, NV 89107-1061
Phone 702-450-1717 · Fax 702-941-6740
Authorized official
Candice D Fortunato
Managing Member
7024501717
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