Healthcare Provider Details

I. General information

NPI: 1023035649
Provider Name (Legal Business Name): GENERAL & VASCULAR SURGERY SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 11/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 S SEACREST BLVD #200
BOYNTON BEACH FL
33435
US

IV. Provider business mailing address

2800 S SEACREST BLVD #200
BOYNTON BEACH FL
33435
US

V. Phone/Fax

Practice location:
  • Phone: 561-736-8200
  • Fax: 561-853-1608
Mailing address:
  • Phone: 561-736-8200
  • Fax: 561-853-1608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME0040155
License Number StateFL

VIII. Authorized Official

Name: GEORGE LESTER MUELLER
Title or Position: PRESIDENT
Credential: MD
Phone: 561-736-8200