Organization
CENTER FOR VEIN RESTORATION FL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJIV LAKHANPAL M.D. (CEO)
(815) 254-1761
Entity
Organization
Contact information
Practice address
15800 PINES BLVD, SUITE 3038, PEMBROKE PINES, FL 33027-1212
(855) 830-8346
(240) 473-4321
Mailing address
7474 GREENWAY CENTER DR, SUITE 1000, GREENBELT, MD 20770-3504
(815) 254-1761
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME125575
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18625
—
AL
05
—
207365460
—
IN
Enumeration date
03/28/2017
Last updated
03/28/2017
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