| Organization Name: | ADVANCED VASCULAR ACCESS, LLC |
| NPI Number: | 1073945614 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HANY ANTON (CEO) |
| Mailing Address: | 20455 Lorain Rd Suite T01 Fairview Park |
| State: | OH US |
| Postal Code: | 441263494 |
| Phone Number: | 4407994811 |
| Fax Number: | 4407994820 |
| NPI Enumeration Date: | 08/06/2013 |
| NPI Last Update Date: | 06/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |