Provider Demographics
NPI:1518044775
Name:VASCULAR AND SPINE INSTITUTE, INC.
Entity Type:Organization
Organization Name:VASCULAR AND SPINE INSTITUTE, INC.
Other - Org Name:VASCULAR AND INTERVENTIONAL SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GRACIELLA
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:RECIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-598-1555
Mailing Address - Street 1:7867 N KENDALL DR STE 130
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7736
Mailing Address - Country:US
Mailing Address - Phone:305-598-1555
Mailing Address - Fax:305-598-1155
Practice Address - Street 1:7867 N KENDALL DR STE 130
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7736
Practice Address - Country:US
Practice Address - Phone:305-598-1555
Practice Address - Fax:305-598-1155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H18070Medicare UPIN