Provider Demographics
NPI:1831482199
Name:VASCULAR ASSOCIATES KENDALL LLC
Entity Type:Organization
Organization Name:VASCULAR ASSOCIATES KENDALL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:PUENTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-596-0600
Mailing Address - Street 1:8955 SW 87TH CT
Mailing Address - Street 2:SUITE 112
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2230
Mailing Address - Country:US
Mailing Address - Phone:305-596-0600
Mailing Address - Fax:305-598-7965
Practice Address - Street 1:8955 SW 87TH CT
Practice Address - Street 2:SUITE 112
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2230
Practice Address - Country:US
Practice Address - Phone:305-596-0600
Practice Address - Fax:305-598-7965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL40804174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty