Provider Demographics
NPI:1508533472
Name:MOUNT SINAI VASCULAR INSTITUTE, LLC
Entity Type:Organization
Organization Name:MOUNT SINAI VASCULAR INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUTKAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-674-2121
Mailing Address - Street 1:PO BOX 527227
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33152-7227
Mailing Address - Country:US
Mailing Address - Phone:305-674-2906
Mailing Address - Fax:305-674-3927
Practice Address - Street 1:3401 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4238
Practice Address - Country:US
Practice Address - Phone:305-674-2906
Practice Address - Fax:305-674-3927
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty