Provider Demographics
NPI:1164060497
Name:ADVANCED VASCULAR CARDIAC & VEINS, PLLC
Entity Type:Organization
Organization Name:ADVANCED VASCULAR CARDIAC & VEINS, PLLC
Other - Org Name:ADVANCED VASCULAR CARDIAC & VEINS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-684-9225
Mailing Address - Street 1:7480 BIRD RD STE 560
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6657
Mailing Address - Country:US
Mailing Address - Phone:305-707-5688
Mailing Address - Fax:305-760-4149
Practice Address - Street 1:7480 BIRD RD STE 560
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6657
Practice Address - Country:US
Practice Address - Phone:305-450-1239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty