Healthcare Provider Details

I. General information

NPI: 1811976004
Provider Name (Legal Business Name): VASCULAR SPECIALISTS OF CENTRAL FLORIDA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 05/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 W MICHIGAN ST
ORLANDO FL
32806-4453
US

IV. Provider business mailing address

80 W MICHIGAN ST
ORLANDO FL
32806-4453
US

V. Phone/Fax

Practice location:
  • Phone: 407-648-4323
  • Fax: 407-839-1493
Mailing address:
  • Phone: 407-648-4323
  • Fax: 407-648-0968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES S THOMPSON
Title or Position: OWNER
Credential: M.D.
Phone: 407-648-4323