Healthcare Provider Details

I. General information

NPI: 1386952869
Provider Name (Legal Business Name): THE VASCULAR GROUP OF NAPLES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2010
Last Update Date: 09/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 GOODLETTE RD N STE 102
NAPLES FL
34103-4595
US

IV. Provider business mailing address

2450 GOODLETTE RD N STE 102
NAPLES FL
34103-4595
US

V. Phone/Fax

Practice location:
  • Phone: 239-643-8794
  • Fax: 239-643-9089
Mailing address:
  • Phone: 239-643-8794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. HIRANYA A RAJASINGHE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 239-643-8794