Endovascular Therapy Associates,Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

ENDOVASCULAR THERAPY ASSOCIATES,INC

Practice address

8900 N Kendall Dr
Miami, FL 33176-2118

Phone

(786) 596-1960

NPI assigned

Jun 20, 2006

Last updated

Oct 18, 2011By 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. Barry T. Katzen, MD

Title

President

Phone

(305) 596-1960

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1619912789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N. NOB HILL ROAD",
            "address_2": "SUITE 273",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241708",
            "telephone_number": "786-596-1960",
            "fax_number": "305-441-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 N KENDALL DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762118",
            "telephone_number": "786-596-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOVASCULAR THERAPY ASSOCIATES,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "KATZEN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-596-1960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259389100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.