Provider Demographics
NPI:1538044979
Name:NEVADA DIABETIC CENTER PLLC
Entity type:Organization
Organization Name:NEVADA DIABETIC CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALVADOR
Authorized Official - Middle Name:
Authorized Official - Last Name:BORROMEO
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:725-218-9741
Mailing Address - Street 1:1771 E FLAMINGO RD STE 213
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5155
Mailing Address - Country:US
Mailing Address - Phone:725-218-9741
Mailing Address - Fax:
Practice Address - Street 1:1771 E FLAMINGO RD STE 213
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5155
Practice Address - Country:US
Practice Address - Phone:725-218-9741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty