Organization
VANGUARD MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIAN HASAN MD (MD)
(954) 436-6660
Entity
Organization
Contact information
Practice address
3401 DAVIE BLVD, FORT LAUDERDALE, FL 33312-2758
(954) 436-6660
(954) 436-6655
Mailing address
603 N FLAMINGO RD STE 150, PEMBROKE PINES, FL 33028-1022
(954) 436-6660
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280980000
—
FL
05
—
280980001
—
FL
Enumeration date
06/29/2017
Last updated
06/29/2017
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