VASANA CHEANVECHAI MD, LTD
Radiology at 20 Ter, Fort Lauderdale, FL

License number
Florida ME70243
Category
Radiology
Type
Vascular Surgery
Owner
Name: MS. STEPHANIE C DAVES
Title: OFFICE MANAGER
Phone: (330) 563-0617
Address
Address
4800 NE 20Th Ter STE 109, Fort Lauderdale, FL 33308
National Provider ID: 1457773210
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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VASANA CHEANVECHAI, M.D., LTD., A NEVADA PROFESSIONAL CORPORATION

Fort Lauderdale, FL

Doing business as:
Vasana Cheanvechai MD
Registration:
Apr 3, 2014
Phone:
(954) 338-3021 (Phone)
Addresses:
4800 NE 20 Ter N BUILDING SUITE 109, Fort Lauderdale, FL 33308 (Physical)
2833 NE 37 Ct, Fort Lauderdale, FL 33308 (Mailing)
State ID:
F14000001487
Business type:
Foreign Profit Corporation
Entity State:
NV
President, Secretary, Treasurer, Vice President:
Vasana Cheanvechai (President, Secretary, Treasurer, Vice President), 2833 NE 37 Ct, Fort Lauderdale, FL 33308 (Physical)
Agent:
Nrai Services, Inc,1200 S Pne Is Rd, Fort Lauderdale, FL 33324 (Physical)
EIN:
20-3717237

Radiology licenses in Florida