Healthcare Provider Details

I. General information

NPI: 1588404198
Provider Name (Legal Business Name): FLORIDA INTERVENTIONAL INSTITUTE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 12/22/2024
Certification Date: 12/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7369 SHERIDAN ST STE 300A
HOLLYWOOD FL
33024-2776
US

IV. Provider business mailing address

7369 SHERIDAN ST STE 300
HOLLYWOOD FL
33024-2776
US

V. Phone/Fax

Practice location:
  • Phone: 305-440-0720
  • Fax:
Mailing address:
  • Phone: 305-204-7276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: PRASOON POOZHIKUNNATH MOHAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 305-204-7276