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General NPI Number Information
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NPI Number | 1639995103
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA VASCULAR INSTITUTE PLLC
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Dates
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Enumeration Date | 11/29/2024
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 8950 SW 74TH CT STE 1408
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City | MIAMI
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State | FL
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Zip | 33156-3173
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Country | US
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Telephone | 833-735-3668
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Fax | 866-897-7014
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Provider Business Mailing Address
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Address Line | 8950 SW 74TH CT STE 1408
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City | MIAMI
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State | FL
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Zip | 33156-3173
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Country | US
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Telephone | 833-735-3668
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Fax | 866-897-7014
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Authorized Official
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Title or Position | OWNER - CEO
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Name | PAUL HANNA
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Credential | DO
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Telephone | 833-735-3668
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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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