Healthcare Provider Details

I. General information

NPI: 1356263149
Provider Name (Legal Business Name): SILUETA FIRM SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3560 E FLAMINGO RD
LAS VEGAS NV
89121-0201
US

IV. Provider business mailing address

3560 E FLAMINGO RD
LAS VEGAS NV
89121-0201
US

V. Phone/Fax

Practice location:
  • Phone: 702-353-1268
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICTE MEDRANO
Title or Position: CEO
Credential:
Phone: 702-353-1268