Healthcare Provider Details

I. General information

NPI: 1720306509
Provider Name (Legal Business Name): VASILE HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 S EAST AVE SUITE 301
SARASOTA FL
34239-2340
US

IV. Provider business mailing address

1219 S EAST AVE SUITE 301
SARASOTA FL
34239-2340
US

V. Phone/Fax

Practice location:
  • Phone: 855-433-2010
  • Fax: 855-433-2010
Mailing address:
  • Phone: 855-433-2010
  • Fax: 855-433-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TRACY ANN VASILE
Title or Position: OWNER
Credential: DO
Phone: 855-433-2010