Advanced Vascular Solutions, LLC
Organization Active NPI Vascular Surgery Physician · Sebastian, FL
NPI 1104459783 · NPPES record last updated Jul 28, 2025
Key facts
- NPI
- 1104459783
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Vascular Surgery Physician 2086S0129X
- Legal business name
- ADVANCED VASCULAR SOLUTIONS, LLC
- Practice address
- 13110 US Highway 1
Sebastian, FL 32958-3735 - Phone
- (772) 581-8900
- NPI assigned
- Feb 21, 2020
- Organization subpart
- No
Authorized official
- Name
- Jad Shalhoub
- Title
- External Consultant
- Phone
- (772) 230-4477
Other NPIs on the same Medicare enrollment 1
Practitioners 10
-
Kerrie Brandes, APRN, FNP-C
-
Lori S Gibbons, ARNP-C
-
Tina Marie McCurry, APRN
-
Sara Kendall Polito, MSN, APRN, FNP-C
-
Sara E Poslaiko, DNP, FNP-BC
-
Hadi A Shalhoub, DO
-
Regina Cocci, APRN
-
Ashlee Paige Thomas, ARNP
-
Sarah V Payne, AGACNP-BC
-
Mark Charles Sultzman, PA-C, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200406003299 | FL | Part B Supplier - Clinic/Group Practice | 2567891955 |
Receives reassigned benefits from 7 practitioners 1 other NPI on this enrollment Practice locations: Melbourne, FL; Sebastian, FL |
National Provider Directory
Locations
584 NW University Blvd
Ste 370
Port St Lucie, FL 34986
Phone (586) 252-0069
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician |
2086S0129X | Yes | ||
| General Practice Physician |
208D00000X |
Addresses
Primary practice location
13110 US Highway 1
Sebastian, FL 32958-3735
Mailing address
13110 US Highway 1
Sebastian, FL 32958-3735
Phone (772) 581-8900
Other practice location 1
1250 S Harbor City Blvd
Melbourne, FL 32901-3242
Phone (321) 725-8919
Other practice location 2
13100 US Highway 1
Sebastian, FL 32958-3735
Phone (772) 581-8900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108804600 | Medicaid | FL |
Other providers in Sebastian, FL
- ABA Service Providers
- Pamela Adan
- Frances Addeo
- Advanced Chiropractic Solutions, LLC
- Advanced Surgical Associates PA
- Advanced Vascular Solutions, LLC
- Scott B Ahrndt
- Aisha Thomas MD LLC
- Alan D Shoopak DMD Orthodontic Group IV LLC
- Anna Marie Alberti
All providers in Sebastian, FL · Vascular Surgery Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.