| Provider / Organization | NPI | Date Certified |
|---|---|---|
| VINCENT ATHAS | 1629634209 | 2021-06-05 |
Vincent Athas is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1629634209. Registration indicates Vincent Athas is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Dr. Vincent Athas MD |
| Practice Office Address | 1600 S ANDREWS AVE FORT LAUDERDALE, FL US |
| Practice Office Telephone | 9544688962 |
| Mailing Address | 1600 S ANDREWS AVE FORT LAUDERDALE, FL 333162510 US |
| Address | City / State | Phone / Fax |
|---|---|---|
| 3601 4th St Rm 3A122B | Lubbock, TX 794300002 | 8067433720 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |