MEDICARE: GENVASCULAR SURGICAL PA

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	208600000X	Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811181423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENVASCULAR SURGICAL PA

Provider Business Mailing Address
First Line	:	3661 S MIAMI AVE STE 610
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-4248
Country	:	US
Telephone Number	:	786-540-2454
Fax Number	:	786-558-1124

Provider Business Practice Location Address
First Line	:	3661 S MIAMI AVE STE 610
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-4248
Country	:	US
Telephone Number	:	786-540-2454
Fax Number	:	786-558-1124

Authorized Official
Title or Position	:	TRES/PROVIDER
Name	:	DR. DANIEL N RAMIREZ
Credential	:	MD
Telephone Number	:	727-376-4570

Provider Enumeration Date	:	08/28/2007
Last Update Date	:	06/13/2019

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Directions to “GENVASCULAR SURGICAL PA ” Practice Location

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