Healthcare Provider Details

I. General information

NPI: 1114336021
Provider Name (Legal Business Name): FLORIDA VEIN CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 E STATE ROAD 64
BRADENTON FL
34208-5533
US

IV. Provider business mailing address

5215 E STATE ROAD 64
BRADENTON FL
34208-5533
US

V. Phone/Fax

Practice location:
  • Phone: 941-907-3400
  • Fax: 941-907-4202
Mailing address:
  • Phone: 941-907-3400
  • Fax: 941-907-4202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: FEDERICO RICHTER
Title or Position: OWNER
Credential: MD
Phone: 941-907-3400