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MINIMALLY INVASIVE VASCULAR INC NPI 1972006351


NPI Information

NPI: 1972006351
Provider Name: MINIMALLY INVASIVE VASCULAR, INC
Classification: Radiology - 2085R0204X
Entity Type: Organization

Specialization: Vascular & Interventional Radiology

CLIA Number: 10D2139386

Address:
2720 US HIGHWAY 1 S STE C
ST AUGUSTINE, FL
ZIP 32086
Phone: (904) 444-0474
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MINIMALLY INVASIVE VASCULAR, INC is a vascular and interventional radiology radiology in St Augustine, FL. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. MINIMALLY INVASIVE VASCULAR, INC NPI is 1972006351. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2720 US HIGHWAY 1 S STE C
ST AUGUSTINE, FL
ZIP 32086-301
Phone: (904) 444-0474

The provider's authorized official is Kok L Chong .
The authorized official title is Owner and has the following contact phone number (904) 320-0680.

The CLIA number assigned to this NPI record is 10D2139386 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 3/13/2018 and was last updated on 8/21/2023.


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
12085R0204XRadiologyVascular & Interventional RadiologyYes

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: 5/5/2024

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