| Organization Name: | COMPREHENSIVE VASCULAR DIAGNOSTICS |
| NPI Number: | 1053547083 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRYAN K JACOBS (DIRECTOR) |
| Mailing Address: | 1892 Bellair Blvd Orange Park |
| State: | FL US |
| Postal Code: | 320734548 |
| Phone Number: | 9045410207 |
| Fax Number: | 9042642067 |
| NPI Enumeration Date: | 06/04/2009 |
| NPI Last Update Date: | 06/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |