MEDICARE: VEINS CARE SPECIALISTS OF SOUTH FLORIDA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME81325	FL

General Provider Information

NPI Number	:	1780780569
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VEINS CARE SPECIALISTS OF SOUTH FLORIDA

Provider Business Mailing Address
First Line	:	1350 TAMIAMI TRL N
Second Line	:	SUITE 205A
City	:	NAPLES
State	:	FL
Zip	:	34102-5203
Country	:	US
Telephone Number	:	239-430-8346
Fax Number	:

Provider Business Practice Location Address
First Line	:	1350 TAMIAMI TRL N
Second Line	:	SUITE 205A
City	:	NAPLES
State	:	FL
Zip	:	34102-5203
Country	:	US
Telephone Number	:	239-430-8346
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARK JOHN MARZANO
Credential	:	M.D.
Telephone Number	:	239-430-8346

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	08/22/2020

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