Provider Demographics
NPI:1942956669
Name:VASCULAR AND INTERVENTIONAL SPECIALISTS, LLC
Entity type:Organization
Organization Name:VASCULAR AND INTERVENTIONAL SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:954-805-3764
Mailing Address - Street 1:PO BOX 565805
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-5805
Mailing Address - Country:US
Mailing Address - Phone:954-805-3764
Mailing Address - Fax:
Practice Address - Street 1:7867 N KENDALL DR STE 130
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7736
Practice Address - Country:US
Practice Address - Phone:305-598-1555
Practice Address - Fax:305-598-1155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty