Organization
KEY WEST VASCULAR INSTITUTE
Active
Organization
KEY WEST VASCULAR INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHELLE THEODORE MPH, MBA (BUSINESS CONSULTANT)
(407) 914-0003
Entity
Organization
Contact information
Practice address
3414 DUCK AVE UNIT 8, KEY WEST, FL 33040-4427
(305) 206-1157
Mailing address
50 NW 15TH ST STE 101, HOMESTEAD, FL 33030-4267
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125598001
—
AR
Enumeration date
08/11/2017
Last updated
08/11/2017
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