# MIVIP REGIONAL SURGERY CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134635097
- **Authorized official:** MRS. ROLANDA JOHNSON (ADMINISTRATOR)
- **Authorized official phone:** (702) 478-7271

## Contact information

- **Practice address:** 5950 S DURANGO DR STE 101, LAS VEGAS, NV 89113
- **Practice address phone:** (702) 478-7271
- **Practice address fax:** (702) 478-8945
- **Mailing address:** 5950 S DURANGO DR STE 101, LAS VEGAS, NV 89113-2270
- **Mailing address phone:** (702) 726-4000
- **Mailing address fax:** (702) 726-4099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/14/2017
- **Last updated:** 09/16/2022