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NPI Code Detail

MEDICARE: MELBOURNE VASCULAR & ENDOVASCULAR CENTER PA

MEDICARE: MELBOURNE VASCULAR & ENDOVASCULAR CENTER PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11730178641OTHERFLFUAD RAMADAN'S INDIV NPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437241270
Entity Type Code : Organization
Provider Name (Legal Business Name) : MELBOURNE VASCULAR & ENDOVASCULAR CENTER PA
Provider Business Mailing Address
First Line : PO BOX 146
Second Line :
City : MELBOURNE
State : FL
Zip : 32902-0146
Country : US
Telephone Number : 321-725-8919
Fax Number : 321-725-8854
Provider Business Practice Location Address
First Line : 1250 S HARBOR CITY BLVD
Second Line : SUITE A
City : MELBOURNE
State : FL
Zip : 32901-3242
Country : US
Telephone Number : 321-725-8919
Fax Number : 321-725-8854
Authorized Official
Title or Position : OWNER
Name : DR. FUAD M RAMADAN
Credential : M.D.
Telephone Number : 321-725-8919
Provider Enumeration Date : 09/29/2006
Last Update Date : 05/12/2016

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Directions to “MELBOURNE VASCULAR & ENDOVASCULAR CENTER PA ” Practice Location

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