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General NPI Number Information
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NPI Number | 1225385842
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Entity Type | Organization
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Legal Business Name | QUICKND PAIN CARE
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 3111 S MARYLAND PKWY STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89109-2319
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Country | US
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Telephone | 702-732-7407
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Fax |
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Provider Business Mailing Address
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Address Line | 3111 S MARYLAND PKWY STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89109-2319
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Country | US
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Telephone | 702-732-7407
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Fax |
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Authorized Official
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Title or Position | MD
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Name | MARIO TARQUINO
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Credential | MD
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Telephone | 702-732-7407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 11543
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License Number State | NY
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