MEDICARE: SOUTH MIAMI BLOOD FLOW ASSOC 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	2085R0202X	Diagnostic Radiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942619168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH MIAMI BLOOD FLOW ASSOC LLC

Provider Business Mailing Address
First Line	:	6200 SW 73RD ST
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4679
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6200 SW 73RD ST
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4679
Country	:	US
Telephone Number	:	786-662-8174
Fax Number	:

Authorized Official
Title or Position	:	AO
Name	:	KAREN VAUGHN
Credential	:
Telephone Number	:	629-317-1465

Provider Enumeration Date	:	08/13/2014
Last Update Date	:	03/25/2026

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