VANGUARD MEDICAL GROUP LLC NPI 1346761392

NPI Information

NPI: 1346761392
Provider Name: VANGUARD MEDICAL GROUP, LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 10D1025088

Address:
3401 DAVIE BLVD
FORT LAUDERDALE, FL
ZIP 33312
Phone: (954) 436-6660
Get Directions

VANGUARD MEDICAL GROUP, LLC is a multi-specialty clinic center in Fort Lauderdale, FL. VANGUARD MEDICAL GROUP, LLC NPI is 1346761392. The provider is registered as an organization entity type.

The provider's business location address is:

3401 DAVIE BLVD
FORT LAUDERDALE, FL
ZIP 33312-758
Phone: (954) 436-6660
Fax: (954) 436-6655

The provider's authorized official is Mian Hasan .
The authorized official title is Md and has the following contact phone number (954) 436-6660.

The CLIA number assigned to this NPI record is 10D1025088 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/29/2017 and was last updated on 6/29/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	280980000	MEDICAID	FLORIDA
2	280980001	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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