Organization
VASCULAR SURGERY ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN FUENTES M.H.A (PRACTICE ADMINISTRATOR)
(850) 877-8539
Entity
Organization
Contact information
Practice address
2631 CENTENNIAL BLVD, STE 100, TALLAHASSEE, FL 32308-0588
(850) 877-8539
(850) 877-6674
Mailing address
2631 CENTENNIAL BLVD, STE 100, TALLAHASSEE, FL 32308-0588
(850) 877-8539
(850) 877-6674
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255471200
—
FL
05
—
300038191A
—
GA
Enumeration date
09/20/2006
Last updated
03/30/2017
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