Provider Demographics
NPI:1265038368
Name:GARBIS VASILACOPULU, DIONISIS (SA-C)
Entity Type:Individual
Prefix:
First Name:DIONISIS
Middle Name:
Last Name:GARBIS VASILACOPULU
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 174TH ST APT 2007
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3256
Mailing Address - Country:US
Mailing Address - Phone:786-613-6982
Mailing Address - Fax:
Practice Address - Street 1:290 174TH ST APT 2007
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3256
Practice Address - Country:US
Practice Address - Phone:786-613-6982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20-454246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant