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General NPI Number Information
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NPI Number | 1508533472
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Entity Type | Organization
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Legal Business Name | MOUNT SINAI VASCULAR INSTITUTE, LLC
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Dates
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Enumeration Date | 08/27/2021
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Last Update Date | 08/27/2021
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Provider Practice Location Address
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Address Line | 3401 NORTHSIDE DR
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City | KEY WEST
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State | FL
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Zip | 33040-4238
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Country | US
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Telephone | 305-674-2906
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Fax | 305-674-3927
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Provider Business Mailing Address
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Address Line | PO BOX 527227
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City | MIAMI
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State | FL
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Zip | 33152-7227
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Country | US
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Telephone | 305-674-2906
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Fax | 305-674-3927
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Authorized Official
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Title or Position | SENIOR VP FINANCE
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Name | WAYNE CHUTKAN
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Credential |
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Telephone | 305-674-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery 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 | 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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