Provider Demographics
NPI:1639995103
Name:SOUTH FLORIDA VASCULAR INSTITUTE PLLC
Entity type:Organization
Organization Name:SOUTH FLORIDA VASCULAR INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:833-735-3668
Mailing Address - Street 1:8950 SW 74TH CT STE 1408
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-3173
Mailing Address - Country:US
Mailing Address - Phone:833-735-3668
Mailing Address - Fax:866-897-7014
Practice Address - Street 1:8950 SW 74TH CT STE 1408
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-3173
Practice Address - Country:US
Practice Address - Phone:833-735-3668
Practice Address - Fax:866-897-7014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-29
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty