Provider Demographics
NPI:1497120513
Name:ALPHA VECTOR LLC
Entity Type:Organization
Organization Name:ALPHA VECTOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:VINER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-701-2317
Mailing Address - Street 1:2637 E ATLANTIC BLVD # 35722
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-4939
Mailing Address - Country:US
Mailing Address - Phone:954-543-0237
Mailing Address - Fax:877-763-2948
Practice Address - Street 1:5900 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4342
Practice Address - Country:US
Practice Address - Phone:305-294-5531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90584207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty