Healthcare Provider Details

I. General information

NPI: 1750672200
Provider Name (Legal Business Name): AVNEET VIG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3683 LOQUAT AVE
MIAMI FL
33133-6217
US

IV. Provider business mailing address

3683 LOQUAT AVE
MIAMI FL
33133-6217
US

V. Phone/Fax

Practice location:
  • Phone: 305-701-4128
  • Fax: 305-564-6364
Mailing address:
  • Phone: 917-673-7331
  • Fax: 305-564-6364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number2752671
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME135290
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: