Provider Demographics
NPI:1982268439
Name:BRANDAO PAIM MARQUES, LUCIANA (MD)
Entity type:Individual
Prefix:DR
First Name:LUCIANA
Middle Name:
Last Name:BRANDAO PAIM MARQUES
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:LUCIANA
Other - Middle Name:
Other - Last Name:PAIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10170 W TROPICANA AVE # 156-252
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8465
Mailing Address - Country:US
Mailing Address - Phone:702-732-1493
Mailing Address - Fax:702-691-5701
Practice Address - Street 1:1 BREAKTHROUGH WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-3011
Practice Address - Country:US
Practice Address - Phone:702-732-1493
Practice Address - Fax:702-732-1080
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN282172080P0216X
TXBP10081525390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLTRN28217Medicaid