Active NPI
Vascular Interventional Pavilion, LLC
Doing business as V.I.P.
- Surgery Physician
- St Petersburg, FL
National Provider Identifier
1427390608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ME106833
- Legal business name
- VASCULAR INTERVENTIONAL PAVILION, LLC
- Doing business as
- V.I.P.
- Practice address
- 3500 38TH Ave N
St Petersburg, FL 33713-1448 - Phone
- (727) 527-5100
- Fax
- (727) 527-5119
- NPI assigned
- Mar 26, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Jordan Steller, MHA
- Title
- Clinic Director
- Phone
- (727) 527-5100
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ME106833 | FL | Primary |
| Vascular Surgery Physician | 2086S0129X | ME106833 | FL |
Addresses
Primary practice location
3500 38TH Ave N
St Petersburg, FL 33713-1448
Mailing address
3520 38TH Ave N
St Petersburg, FL 33713-1448
Phone (727) 527-5100
Other names 1
- V.I.P.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364256000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1364256000000",
"number": "1427390608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3520 38TH AVE N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337131448",
"telephone_number": "727-527-5100",
"fax_number": "727-527-5119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 38TH AVE N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337131448",
"telephone_number": "727-527-5100",
"fax_number": "727-527-5119"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VASCULAR INTERVENTIONAL PAVILION, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-03-26",
"last_updated": "2013-03-26",
"status": "A",
"authorized_official_last_name": "STELLER",
"authorized_official_first_name": "JORDAN",
"authorized_official_title_or_position": "CLINIC DIRECTOR",
"authorized_official_telephone_number": "727-527-5100",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "MHA"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": "FL",
"license": "ME106833",
"primary": true
},
{
"code": "2086S0129X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery, Vascular Surgery",
"state": "FL",
"license": "ME106833",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "V.I.P.",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.