Organization
ADVANCED VASCULAR INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHMED ALY FARAG MD (CMO)
(850) 628-9177
Entity
Organization
Contact information
Practice address
2401 STATE AVE STE 100, PANAMA CITY, FL 32405-3942
(502) 262-5980
Mailing address
2401 STATE AVE STE 100, PANAMA CITY, FL 32405-3942
(502) 262-5980
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
02/08/2024
Last updated
03/05/2025
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