Provider Demographics
NPI:1811181423
Name:GENVASCULAR SURGICAL PA
Entity type:Organization
Organization Name:GENVASCULAR SURGICAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRES/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-376-4570
Mailing Address - Street 1:3661 S MIAMI AVE STE 610
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4248
Mailing Address - Country:US
Mailing Address - Phone:786-540-2454
Mailing Address - Fax:786-558-1124
Practice Address - Street 1:3661 S MIAMI AVE STE 610
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4248
Practice Address - Country:US
Practice Address - Phone:786-540-2454
Practice Address - Fax:786-558-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty