Provider Demographics
NPI:1033743240
Name:VASCULAR INSTITUTE OF CLEVELAND, LLC
Entity Type:Organization
Organization Name:VASCULAR INSTITUTE OF CLEVELAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARREDONDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-839-0692
Mailing Address - Street 1:18375 VENTURA BLVD STE 554
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4218
Mailing Address - Country:US
Mailing Address - Phone:216-839-0692
Mailing Address - Fax:805-790-0010
Practice Address - Street 1:12575 ROCKSIDE RD STE 102
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-4571
Practice Address - Country:US
Practice Address - Phone:216-839-0692
Practice Address - Fax:805-790-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty