Organization
PLATINUM SURGICAL ASSOSIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VERN VONTRICE PALMER CSFA (CEO)
(702) 325-8928
Entity
Organization
Contact information
Practice address
4140 INGLEWOOD POINT ST, NORTH LAS VEGAS, NV 89032-1147
(702) 361-8571
Mailing address
4140 INGLEWOOD POINT ST, NORTH LAS VEGAS, NV 89032-1147
Taxonomy
Speciality
Code
Description
License number
State
211D00000X
Podiatric Assistant
171630
NV
246ZC0007X
Surgical Assistant
Primary
171630
NV
261QA1903X
Ambulatory Surgical Clinic/Center
171630
NV
Other
Enumeration date
01/03/2017
Last updated
01/03/2017
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