Healthcare Provider Details

I. General information

NPI: 1316413115
Provider Name (Legal Business Name): FOX VASCULAR EXPERTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2018
Last Update Date: 10/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2699 STIRLING RD STE A301302
FORT LAUDERDALE FL
33312-6517
US

IV. Provider business mailing address

4780 SW 64TH AVE STE 103
DAVIE FL
33314-4400
US

V. Phone/Fax

Practice location:
  • Phone: 954-965-4922
  • Fax: 954-515-1184
Mailing address:
  • Phone: 954-434-1705
  • Fax: 800-642-2398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LUIS FELIPE LAFRATTA
Title or Position: CEO
Credential:
Phone: 954-434-1705