Center for Vein Restoration FL LLC

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

ME125575 Issued in FL

Legal business name

CENTER FOR VEIN RESTORATION FL LLC

Practice address

15800 Pines Blvd
Suite 3038
Pembroke Pines, FL 33027-1212

Phone

(855) 830-8346

Fax

(240) 473-4321

NPI assigned

Mar 28, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Sanjiv Lakhanpal, M.D.

Title

Ceo

Phone

(815) 254-1761

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1124550421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7474 GREENWAY CENTER DR",
            "address_2": "SUITE 1000",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703504",
            "telephone_number": "815-254-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15800 PINES BLVD",
            "address_2": "SUITE 3038",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271212",
            "telephone_number": "855-830-8346",
            "fax_number": "240-473-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR VEIN RESTORATION FL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2017-03-28",
        "status": "A",
        "authorized_official_last_name": "LAKHANPAL",
        "authorized_official_first_name": "SANJIV",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "815-254-1761",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME125575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18625",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207365460",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.