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General NPI Number Information
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NPI Number | 1164425005
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Entity Type | Individual
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Provider Name | HORACIO M VASSOLO MD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 2801 NE 213TH ST STE 1015
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City | AVENTURA
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State | FL
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Zip | 33180-1266
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Country | US
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Telephone | 786-753-5898
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Fax | 786-756-0205
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Provider Business Mailing Address
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Address Line | 2801 NE 213TH ST STE 1015
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City | AVENTURA
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State | FL
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Zip | 33180-1266
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Country | US
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Telephone | 786-753-5898
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Fax | 786-756-0205
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME68805
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License Number State | FL
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