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Organization

LAS OLAS DE SEQUOIA LLC

Active
Other names
Lifeline Vascular Center - Ft Lauderdale
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES HILGER (CHIEF ACCOUNTING OFFICER)
(253) 280-9501
Entity
Organization

Contact information

Practice address
6766 W SUNRISE BLVD, SUITE 100, PLANTATION, FL 33313-6072
(847) 388-2001
(847) 388-2020
Mailing address
3 W HAWTHORN PKWY, SUITE 410, VERNON HILLS, IL 60061-1446
(847) 388-2001
(847) 388-2020

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
2085R0204X
Vascular & Interventional Radiology Physician
Primary
2086S0129X
Vascular Surgery Physician

Other

Enumeration date
09/28/2012
Last updated
09/28/2012
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