Provider Demographics
NPI:1477537868
Name:VARGAS, ABELARDO (MD)
Entity Type:Individual
Prefix:
First Name:ABELARDO
Middle Name:
Last Name:VARGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0018625208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL049858100Medicaid
FL049858100Medicaid
FL91297ZMedicare UPIN