Organization
MINIMALLY INVASIVE VASCULAR, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOK L CHONG MD (OWNER)
(904) 320-0680
Entity
Organization
Contact information
Practice address
2720 US HIGHWAY 1 S STE C, ST AUGUSTINE, FL 32086-6301
(904) 444-0474
Mailing address
2720 US HIGHWAY 1 S STE C, ST AUGUSTINE, FL 32086-6301
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
03/13/2018
Last updated
08/21/2023
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