Provider Demographics
NPI:1992117188
Name:VASCULAR INTERVENTION PARTNERS, LLC
Entity type:Organization
Organization Name:VASCULAR INTERVENTION PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRED MANGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:M,D
Authorized Official - Phone:859-948-2390
Mailing Address - Street 1:155 S COURT AVE
Mailing Address - Street 2:APT 2602
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3205
Mailing Address - Country:US
Mailing Address - Phone:407-496-7611
Mailing Address - Fax:863-299-3960
Practice Address - Street 1:1015 6TH ST NW
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-6247
Practice Address - Country:US
Practice Address - Phone:407-496-7611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1005292085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME100529OtherMEDICAL LICENSE