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General NPI Number Information
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NPI Number | 1699694190
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Entity Type | Organization
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Legal Business Name | PAINTED MIRAGE SURGERY CENTER, LLC
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 5550 PAINTED MIRAGE RD STE 115
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City | LAS VEGAS
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State | NV
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Zip | 89149-4581
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Country | US
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Telephone | 702-456-0025
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Fax | 702-456-0025
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Provider Business Mailing Address
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Address Line | 5550 PAINTED MIRAGE RD STE 115
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City | LAS VEGAS
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State | NV
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Zip | 89149-4581
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Country | US
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Telephone | 702-456-0025
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Fax | 702-456-0025
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AMANDA DEAN
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Credential |
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Telephone | 702-456-0025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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