Organization
KANSAS CITY VASCULAR INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN CARLOS CORREA MD (MD/OWNER)
(314) 698-8894
Entity
Organization
Contact information
Practice address
5320 COLLEGE BLVD, LEAWOOD, KS 66211-1621
(913) 279-0233
(830) 632-6568
Mailing address
5320 COLLEGE BLVD, LEAWOOD, KS 66211-1621
(913) 279-0233
(830) 632-6568
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004944060001
—
KS
05
—
500124730
—
MO
Enumeration date
04/14/2023
Last updated
05/23/2025
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