# QUEENSRIDGE CARDIOLOGY CENTER LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** QUEENSRIDGE CARDIOLOGY CENTER LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205564663
- **Authorized official:** ROBERT LERMA MS,MBA,CASC (ADMINISTRATOR)
- **Authorized official phone:** (702) 589-9250

## Contact information

- **Practice address:** 10040 ALTA DRIVE, SUITE 250, LAS VEGAS, NV 89145-8905
- **Practice address phone:** (702) 589-9250
- **Practice address fax:** (702) 589-9257
- **Mailing address:** 2779 W HORIZON RIDGE PKWY STE 140, HENDERSON, NV 89052-4186
- **Mailing address phone:** (702) 589-9250
- **Mailing address fax:** (702) 589-9257

## Taxonomy

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

## Other

- **Enumeration date:** 08/12/2022
- **Last updated:** 08/12/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1043652906 | COMMERCIAL PAYRORS | NV |