MEDICARE: VANGUARD MEDICAL GROUP LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1912202797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANGUARD MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	1330 RIVERLAND RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-2961
Country	:	US
Telephone Number	:	954-321-9826
Fax Number	:	954-321-9660

Provider Business Practice Location Address
First Line	:	1330 RIVERLAND RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-2961
Country	:	US
Telephone Number	:	954-321-9826
Fax Number	:	954-321-9660

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. MIAN A HASAN
Credential	:	MD,FACCC,FACP,FSCAI
Telephone Number	:	954-436-6660

Provider Enumeration Date	:	01/25/2011
Last Update Date	:	01/25/2011

Similar Medicare Providers

1215880968 — SELAMAWIT TESFAMARIAM
Practice Location Address:

1300 RIVERLAND RD
FORT LAUDERDALE, FL
33312-2961

Practice Phone: 954-483-9744
Practice Fax:

1376658294 — BROWARD MEDICAL CENTER OF DAVIE INC
Practice Location Address:

1330 RIVERLAND RD
FORT LAUDERDALE, FL
33312-2961

Practice Phone: 954-321-9826
Practice Fax: 954-321-9660

1912012816 — JENNIFER RIDENOURE P.A.C
Practice Location Address:

1330 RIVERLAND RD
FORT LAUDERDALE, FL
33312-2961

Practice Phone: 954-321-9826
Practice Fax: 954-321-9660

1265633903 — DR. ANGELA MARIA RODRIGUEZ MD
Practice Location Address:

1330 RIVERLAND RD
FORT LAUDERDALE, FL
33312-2961

Practice Phone: 954-321-9826
Practice Fax: 954-321-9660

1871824771 — VERONICA O'CONNOR
Practice Location Address:

1330 RIVERLAND RD
FT LAUDERDALE, FL
33312-2961

Practice Phone: 954-321-9826
Practice Fax: 954-321-9660

1396698429 — CARLA P CARRATALA
Practice Location Address:

2410 SW 54TH ST
FORT LAUDERDALE, FL
33312-7443

Practice Phone: 954-682-2348
Practice Fax:

Directions to “VANGUARD MEDICAL GROUP LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.