Provider Demographics
NPI:1538261896
Name:ALL AMERICAN SURGICAL LLC
Entity type:Organization
Organization Name:ALL AMERICAN SURGICAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MARANON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-889-9129
Mailing Address - Street 1:2675 S JONES BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5607
Mailing Address - Country:US
Mailing Address - Phone:702-889-9129
Mailing Address - Fax:702-562-5069
Practice Address - Street 1:2675 S JONES BLVD STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5607
Practice Address - Country:US
Practice Address - Phone:702-889-9129
Practice Address - Fax:702-562-5069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7873174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV32809Medicare ID - Type UnspecifiedMEDICARE ID #
NVV32808Medicare PIN