Vanguard Medical Group, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

VANGUARD MEDICAL GROUP, LLC

Practice address

3401 Davie Blvd
Fort Lauderdale, FL 33312-2758

Phone

(954) 436-6660

Fax

(954) 436-6655

NPI assigned

Jun 29, 2017

Last updated

Jun 29, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mian Hasan, MDNPI 1366407868

Title

MD

Phone

(954) 436-6660

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Davie BLD Fort Lauderdale2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vanguard Medical Group, LLC

  • Specialist
  • Pembroke Pines, FL
  • NPI 1174608699
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mian A Hasan, MD

  • Cardiovascular Disease Physician
  • Pembroke Pines, FL
  • NPI 1366407868
  Authorized official Same address or phone

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498694400000",
    "number": "1346761392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 N FLAMINGO RD STE 150",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281022",
            "telephone_number": "954-436-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 DAVIE BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333122758",
            "telephone_number": "954-436-6660",
            "fax_number": "954-436-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-29",
        "last_updated": "2017-06-29",
        "status": "A",
        "authorized_official_last_name": "HASAN",
        "authorized_official_first_name": "MIAN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "954-436-6660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280980000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280980001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Vanderlely, M.S., ITDS
• Marjan Vandevar, D.O.
• Vanguard Catheterization Lab
• Vanguard Medical Associates of South Florida PA
• Vanguard Medical Group LLC (Broward Primary Care)
• Vanguard Medical Supply
• Vanguard Plastic Surgery LLC (Vanguard Aesthetic & Plastic Surgery)
• Lyska Anyssa Vante Richetti
• Saynur Vardar-Sengul, DDS, PHD
• Netty Varela, LMHC

• Multi-Specialty Clinic/Center in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.