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Organization

ADVANCED VASCULAR CARE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBBIE JEAN ANDERSON CIMCS (MEDICAL CLAIM SPECIALIST)
(850) 543-8960
Entity
Organization

Contact information

Practice address
2010 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547-1352
(305) 662-5200
(305) 284-7913
Mailing address
4516 E HIGHWAY 20, SUITE 226, NICEVILLE, FL 32578-9755
(305) 662-5200
(305) 284-7913

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
011996100
FL
01
1063852192
NPI
01
14V4Q
BC
Enumeration date
10/16/2015
Last updated
01/15/2016
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