MEDICARE: VASCULAR IMAGING ASSOCIATES INC

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
1	246XS1301X	Sonography Specialist/Technologist Cardiovascular	HCC6870	FL

General Provider Information

NPI Number	:	1801992409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VASCULAR IMAGING ASSOCIATES INC

Provider Business Mailing Address
First Line	:	1325 S CONGRESS AVE
Second Line	:	SUITE 108
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-5876
Country	:	US
Telephone Number	:	561-737-0703
Fax Number	:	561-737-4632

Provider Business Practice Location Address
First Line	:	1325 S CONGRESS AVE
Second Line	:	SUITE 108
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-5876
Country	:	US
Telephone Number	:	561-737-0703
Fax Number	:	561-737-4632

Authorized Official
Title or Position	:	OWNER
Name	:	PATRICIA T SHANDLOFF
Credential	:	RN, RVT
Telephone Number	:	561-737-0703

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	05/21/2009

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