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General NPI Number Information
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NPI Number | 1801652086
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Entity Type | Individual
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Provider Name | LIAMNE GONZALEZ SARDINAS SA-C
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Gender | Female
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 5380 E FLAMINGO RD SPC 9
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City | LAS VEGAS
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State | NV
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Zip | 89122-5339
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Country | US
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Telephone | 702-326-4283
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Fax |
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Provider Business Mailing Address
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Address Line | 5380 E FLAMINGO RD SPC 9
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City | LAS VEGAS
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State | NV
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Zip | 89122-5339
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Country | US
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Telephone | 702-326-4283
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 24-162
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License Number State | NV
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