Provider Demographics
NPI:1871576579
Name:VINAS, LUIS ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:ANTONIO
Last Name:VINAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:550 S QUADRILLE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5855
Mailing Address - Country:US
Mailing Address - Phone:561-655-3305
Mailing Address - Fax:561-655-3951
Practice Address - Street 1:550 S QUADRILLE BLVD
Practice Address - Street 2:STE 100
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-5855
Practice Address - Country:US
Practice Address - Phone:561-655-3305
Practice Address - Fax:561-655-3951
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME57391208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063884600Medicaid
BV2238752OtherDEA
E66936Medicare UPIN
FL063884600Medicaid