Provider Demographics
NPI:1982607289
Name:TSOUKAS, ATHANASSIOS I (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:ATHANASSIOS
Middle Name:I
Last Name:TSOUKAS
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 198054
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8054
Mailing Address - Country:US
Mailing Address - Phone:786-662-7980
Mailing Address - Fax:
Practice Address - Street 1:8950 N KENDALL DR STE 504W
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2127
Practice Address - Country:US
Practice Address - Phone:305-274-2030
Practice Address - Fax:786-533-7053
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME772992086S0129X
FLME-00772992086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22-81272OtherUNITED HEALTHCARE
FL7724587OtherAETNA
FL265553-500Medicaid
FL042277OtherNEIGHBORHOOD HEALTH PLAN
FL2648297002OtherCIGNA
FL288181OtherAVMED
FL2648297002OtherCIGNA
FLH-74937Medicare UPIN