Basic Information
| Provider Information | |||||||||
| NPI: | 1720306509 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VASILE HOLDINGS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1219 S EAST AVE | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342392340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8554332010 | ||||||||
| FaxNumber: | 8554332010 | ||||||||
| Practice Location | |||||||||
| Address1: | 1219 S EAST AVE | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342392340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8554332010 | ||||||||
| FaxNumber: | 8554332010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2010 | ||||||||
| LastUpdateDate: | 01/17/2017 | ||||||||
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| AuthorizedOfficialLastName: | VASILE | ||||||||
| AuthorizedOfficialFirstName: | TRACY | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8554332010 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 208D00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.