Provider Demographics
NPI:1144383175
Name:ABELARDO VARGAS MDPA
Entity Type:Organization
Organization Name:ABELARDO VARGAS MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABELARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MDPA
Authorized Official - Phone:305-792-4830
Mailing Address - Street 1:16400 COLLINS AVE APT 746
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4568
Mailing Address - Country:US
Mailing Address - Phone:305-792-4830
Mailing Address - Fax:305-792-4832
Practice Address - Street 1:16400 COLLINS AVE APT 746
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4568
Practice Address - Country:US
Practice Address - Phone:305-792-4830
Practice Address - Fax:305-792-4832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0018625208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL049585100Medicaid
FL8P108AMedicare UPIN
FL049585100Medicaid