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General NPI Number Information
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NPI Number | 1154781771
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Entity Type | Organization
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Legal Business Name | VSI RAD LLC
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 02/24/2016
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Provider Practice Location Address
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Address Line | 1475 W 49TH PL
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City | HIALEAH
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State | FL
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Zip | 33012-3113
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Country | US
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Telephone | 305-558-2500
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Fax | 305-666-1065
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Provider Business Mailing Address
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Address Line | 5927 SW 70TH #439031
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City | MIAMI
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State | FL
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Zip | 33143-9998
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Country | US
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Telephone | 305-666-2427
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Fax | 305-666-1065
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. OSMANY DEANGELO
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Credential | D.O
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Telephone | 305-598-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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