Provider Demographics
NPI:1629008677
Name:OPEN ACCESS VASCULAR ACCESS CENTER, INC
Entity Type:Organization
Organization Name:OPEN ACCESS VASCULAR ACCESS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-948-5333
Mailing Address - Street 1:16401 NW 2ND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6036
Mailing Address - Country:US
Mailing Address - Phone:305-948-5333
Mailing Address - Fax:305-348-3246
Practice Address - Street 1:16401 NW 2ND AVE STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6036
Practice Address - Country:US
Practice Address - Phone:305-948-5333
Practice Address - Fax:305-348-3246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33254OtherBCBS OF FL GROUP PIN
FLK1447Medicare ID - Type UnspecifiedGROUP NUMBER