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Organization
QUEENSRIDGE CARDIOLOGY CENTER LLC
Active
Organization
QUEENSRIDGE CARDIOLOGY CENTER LLC
Active
Other names
QUEENSRIDGE CARDIOLOGY CENTER LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LERMA MS,MBA,CASC (ADMINISTRATOR)
(702) 589-9250
Entity
Organization
Contact information
Practice address
10040 ALTA DRIVE, SUITE 250, LAS VEGAS, NV 89145-8905
(702) 589-9250
(702) 589-9257
Mailing address
2779 W HORIZON RIDGE PKWY STE 140, HENDERSON, NV 89052-4186
(702) 589-9250
(702) 589-9257
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043652906
COMMERCIAL PAYRORS
NV
Enumeration date
08/12/2022
Last updated
08/12/2022
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