MEDICARE: ARIANA COSMETIC SURGERY AND LASER CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1689879488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIANA COSMETIC SURGERY AND LASER CENTER

Provider Business Mailing Address
First Line	:	5876 S PECOS RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3418
Country	:	US
Telephone Number	:	702-733-1333
Fax Number	:	702-733-1003

Provider Business Practice Location Address
First Line	:	5876 S PECOS RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3418
Country	:	US
Telephone Number	:	702-733-1333
Fax Number	:	702-733-1003

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. ELLEN KAMEEHONUA
Credential	:
Telephone Number	:	702-733-1333

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	08/22/2020

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