Provider Demographics
NPI:1568552321
Name:SOUTH FLORIDA VASCULAR ASSOCIATES
Entity Type:Organization
Organization Name:SOUTH FLORIDA VASCULAR ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, SFVA
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:JULIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-725-4141
Mailing Address - Street 1:5300 W HILLSBORO BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4395
Mailing Address - Country:US
Mailing Address - Phone:954-725-4141
Mailing Address - Fax:954-206-0149
Practice Address - Street 1:5300 W HILLSBORO BLVD STE 107
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4395
Practice Address - Country:US
Practice Address - Phone:954-725-4141
Practice Address - Fax:954-725-4141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3713822200Medicaid
FL3713822200Medicaid
FLE60352Medicare UPIN