Healthcare Provider Details

I. General information

NPI: 1982268439
Provider Name (Legal Business Name): LUCIANA BRANDAO PAIM MARQUES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LUCIANA PAIM

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BREAKTHROUGH WAY
LAS VEGAS NV
89135-3011
US

IV. Provider business mailing address

10170 W TROPICANA AVE # 156-252
LAS VEGAS NV
89147-8465
US

V. Phone/Fax

Practice location:
  • Phone: 702-732-1493
  • Fax: 702-732-1080
Mailing address:
  • Phone: 702-732-1493
  • Fax: 702-691-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License NumberTRN28217
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberBP10081525
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: