Organization Active NPI

Fort Lauderdale Vascular Access, LLC

  • Vascular & Interventional Radiology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1124380365
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
FORT LAUDERDALE VASCULAR ACCESS, LLC
Practice address
3601 W Commercial Blvd
Suite 21
Fort Lauderdale, FL 33309-3300
Phone
(954) 497-2161
Fax
(954) 535-5507
NPI assigned
Jun 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Ronald H. Rodgers Jr.
Title
President
Phone
(610) 644-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X Primary

Addresses

Primary practice location

3601 W Commercial Blvd
Suite 21
Fort Lauderdale, FL 33309-3300

Mailing address

182 Industrial Rd
Glen Rock, PA 17327-8626
Phone (717) 759-6739

National Provider Directory

National Provider Directory

Locations

3601 W Commercial Blvd
Ste 21
Ft Lauderdale, FL 33309
Phone (954) 497-2161

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369958400000",
    "number": "1124380365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 INDUSTRIAL RD",
            "city": "GLEN ROCK",
            "state": "PA",
            "postal_code": "173278626",
            "telephone_number": "717-759-6739",
            "fax_number": "717-235-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W COMMERCIAL BLVD",
            "address_2": "SUITE 21",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093300",
            "telephone_number": "954-497-2161",
            "fax_number": "954-535-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT LAUDERDALE VASCULAR ACCESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-13",
        "last_updated": "2013-05-31",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-644-8900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.