Provider Demographics
NPI:1679590483
Name:VASCULAR ULTRASOUND SERVICES, INC
Entity Type:Organization
Organization Name:VASCULAR ULTRASOUND SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:CRISTO
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:RVT, RCS, RNCST
Authorized Official - Phone:813-990-8500
Mailing Address - Street 1:7109 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-5262
Mailing Address - Country:US
Mailing Address - Phone:813-990-8500
Mailing Address - Fax:813-990-8600
Practice Address - Street 1:7109 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-5262
Practice Address - Country:US
Practice Address - Phone:813-990-8500
Practice Address - Fax:813-990-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4371293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE1534Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER