Provider Demographics
NPI:1083501597
Name:PALLIATIVE CARE OF LAS VEGAS, LLC
Entity type:Organization
Organization Name:PALLIATIVE CARE OF LAS VEGAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY BRANDO
Authorized Official - Middle Name:SO
Authorized Official - Last Name:OPIMO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, AGACNP-BC
Authorized Official - Phone:702-849-2504
Mailing Address - Street 1:4938 JEREMY DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-0104
Mailing Address - Country:US
Mailing Address - Phone:702-849-2504
Mailing Address - Fax:
Practice Address - Street 1:4938 JEREMY DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0104
Practice Address - Country:US
Practice Address - Phone:702-849-2504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center