Provider Demographics
NPI:1669460945
Name:JANIN HEART & VASCULAR INSTITUTE PA
Entity Type:Organization
Organization Name:JANIN HEART & VASCULAR INSTITUTE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YVES
Authorized Official - Middle Name:
Authorized Official - Last Name:JANIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-694-6901
Mailing Address - Street 1:840 US HIGHWAY 1
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3830
Mailing Address - Country:US
Mailing Address - Phone:561-626-9021
Mailing Address - Fax:561-626-7593
Practice Address - Street 1:4601 MILITARY TRL
Practice Address - Street 2:SUITE 207
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4834
Practice Address - Country:US
Practice Address - Phone:561-694-6901
Practice Address - Fax:561-694-6902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME0076640207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261299200Medicaid
FL03136OtherBCBS
FLE5670ZMedicare ID - Type UnspecifiedINDIVIDUAL
FL03136OtherBCBS
FL261299200Medicaid