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
—
—
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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