CARDIAC & VASCULAR SURGERY SPECIALIST PA NPI 1740468396

NPI Information

CARDIAC & VASCULAR SURGERY SPECIALIST, PA is a vascular surgery surgery in Gainesville, FL. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. CARDIAC & VASCULAR SURGERY SPECIALIST, PA NPI is 1740468396. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Vascular Surgery Specialists.

The provider's business location address is:

1121 NW 64TH TERR.
STE A
GAINESVILLE, FL
ZIP 32605
Phone: (352) 331-6777
Fax: (352) 331-8899

The provider's authorized official is Elmer E. Croushore .
The authorized official title is Owner and has the following contact phone number (352) 331-6777.

The CLIA number assigned to this NPI record is 10D1093079 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/6/2008 and was last updated on 1/29/2013.

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:

Other Identifiers

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