Organization
SOUTHEAST VASCULAR GROUP LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAYNE R. YONEHIRO MD (PRESIDENT)
(850) 429-0102
Entity
Organization
Contact information
Practice address
4800 N 9TH AVE, PENSACOLA, FL 32503-2447
(850) 429-0102
(850) 429-0830
Mailing address
PO BOX 30090, PENSACOLA, FL 32503-1090
(850) 429-0102
(850) 429-0803
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME35697
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0329
HEALTH FIRST NETWORK
FL
05
—
266355400
—
FL
05
—
529913680
—
AL
05
—
529929230
—
AL
05
—
529931590
—
AL
01
—
CK8716
MEDICARE RAILROAD
FL
Enumeration date
12/09/2005
Last updated
06/10/2021
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