Provider Demographics
NPI:1609608934
Name:INGUANZO CARDOSO, ZEUS D
Entity type:Individual
Prefix:
First Name:ZEUS
Middle Name:D
Last Name:INGUANZO CARDOSO
Suffix:
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 1:8290 W SAHARA AVE STE 156
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8932
Mailing Address - Country:US
Mailing Address - Phone:702-574-9830
Mailing Address - Fax:
Practice Address - Street 1:8290 W SAHARA AVE STE 156
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8932
Practice Address - Country:US
Practice Address - Phone:702-574-9830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty