MEDICARE: AMIRA AZIM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		NV

General Provider Information

NPI Number	:	1649139387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIRA AZIM

Provider Business Mailing Address
First Line	:	8814 BIG BLUFF AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1418
Country	:	US
Telephone Number	:	702-726-1424
Fax Number	:

Provider Business Practice Location Address
First Line	:	5765 S RAINBOW BLVD STE 101-102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2536
Country	:	US
Telephone Number	:	702-412-8578
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ AMIRA AZIM ” Practice Location

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