| Advanced Vascular Solutions, Llc | |
|
13110 Us Highway 1 Sebastian FL 32958-3735 | |
| (772) 581-8900 | |
| Not Available |
| Full Name | Advanced Vascular Solutions, Llc |
|---|---|
| Speciality | Surgery |
| Location | 13110 Us Highway 1, Sebastian, Florida |
| Authorized Official Name and Position | Jad Shalhoub (EXTERNAL CONSULTANT) |
| Authorized Official Contact | 7722304477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Vascular Solutions, Llc 13110 Us Highway 1 Sebastian FL 32958-3735 Ph: (772) 581-8900 | Advanced Vascular Solutions, Llc 13110 Us Highway 1 Sebastian FL 32958-3735 Ph: (772) 581-8900 |
| NPI Number | 1104459783 |
|---|---|
| Provider Enumeration Date | 02/21/2020 |
| Last Update Date | 01/19/2023 |
| Medicare PECOS PAC ID | 2567891955 |
|---|---|
| Medicare Enrollment ID | O20200406003299 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104459783 | NPI | - | NPPES |
| 108804600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | (* (Not Available)) | Primary |
| Provider Name | Hadi Shalhoub |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1922152842 PECOS PAC ID: 3274691928 Enrollment ID: I20081023000746 |
| Provider Name | Lori S Gibbons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689804023 PECOS PAC ID: 9335294842 Enrollment ID: I20090908000064 |
| Provider Name | Sara E Poslaiko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629693734 PECOS PAC ID: 9638583834 Enrollment ID: I20210129001411 |
| Provider Name | Ashlee Paige Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285209700 PECOS PAC ID: 6103220025 Enrollment ID: I20210813001681 |
| Provider Name | Sara Kendall Polito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598549768 PECOS PAC ID: 0345690145 Enrollment ID: I20231220000101 |
| Provider Name | Tina Marie Mccurry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184480485 PECOS PAC ID: 6305385584 Enrollment ID: I20240902000539 |
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