Provider Demographics
NPI:1679713473
Name:L A VINAS MD PA
Entity type:Organization
Organization Name:L A VINAS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:VINAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-655-3305
Mailing Address - Street 1:550 S QUADRILLE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5855
Mailing Address - Country:US
Mailing Address - Phone:561-655-3305
Mailing Address - Fax:561-736-2766
Practice Address - Street 1:550 S QUADRILLE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-5855
Practice Address - Country:US
Practice Address - Phone:561-655-3305
Practice Address - Fax:561-736-2766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10932Medicare PIN