Healthcare Provider Details
I. General information
NPI: 1104745967
Provider Name (Legal Business Name): ROWAN VASCULAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5305 GRAND BLVD
NEW PORT RICHEY FL
34652-4014
US
IV. Provider business mailing address
5305 GRAND BLVD
NEW PORT RICHEY FL
34652-4014
US
V. Phone/Fax
- Phone: 727-247-5977
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CAREY
ROWAN
Title or Position: MANAGER
Credential: MD
Phone: 727-247-5977