Provider Demographics
NPI:1417142035
Name:SEBRING VASCULAR SURGERY PL
Entity Type:Organization
Organization Name:SEBRING VASCULAR SURGERY PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREISDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-382-2361
Mailing Address - Street 1:3323 MEDICAL HILL RD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5531
Mailing Address - Country:US
Mailing Address - Phone:863-382-2361
Mailing Address - Fax:863-382-4327
Practice Address - Street 1:3323 MEDICAL HILL RD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5531
Practice Address - Country:US
Practice Address - Phone:863-382-2361
Practice Address - Fax:863-382-4327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME853812086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty