Provider Demographics
NPI:1881909356
Name:MENGHANI, VIKAS (MD)
Entity type:Individual
Prefix:DR
First Name:VIKAS
Middle Name:
Last Name:MENGHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W BOUTZ RD
Mailing Address - Street 2:BLDG 1
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3259
Mailing Address - Country:US
Mailing Address - Phone:575-532-7000
Mailing Address - Fax:575-532-7025
Practice Address - Street 1:600 NE 36TH ST
Practice Address - Street 2:#516
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3929
Practice Address - Country:US
Practice Address - Phone:415-374-3545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN146142085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology