Provider Demographics
NPI:1194993170
Name:SARKISIAN, VAHE MIKE (CPED)
Entity type:Individual
Prefix:
First Name:VAHE
Middle Name:MIKE
Last Name:SARKISIAN
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6593 WESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-3951
Mailing Address - Country:US
Mailing Address - Phone:718-551-6101
Mailing Address - Fax:
Practice Address - Street 1:6593 WESTVIEW DR
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-3951
Practice Address - Country:US
Practice Address - Phone:718-551-6101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPED 150174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist