Provider Demographics
NPI:1982607289
Name:TSOUKAS, ATHANASSIOS I (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:ATHANASSIOS
Middle Name:I
Last Name:TSOUKAS
Suffix:
Gender:M
Credentials:MD, FACS
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Mailing Address - Street 1:8950 N KENDALL DR
Mailing Address - Street 2:STE 504W
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2144
Mailing Address - Country:US
Mailing Address - Phone:305-274-2030
Mailing Address - Fax:305-279-0878
Practice Address - Street 1:8950 N KENDALL DR
Practice Address - Street 2:SUITE 504W
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:305-274-2030
Practice Address - Fax:305-279-0878
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME-0077299208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7724587OtherAETNA
FL22-81272OtherUNITED HEALTHCARE
FL2648297002OtherCIGNA
FL288181OtherAVMED
FL265553-500Medicaid
FL042277OtherNEIGHBORHOOD HEALTH PLAN
FL2648297002OtherCIGNA
FLH-74937Medicare UPIN