Healthcare Provider Details

I. General information

NPI: 1912149642
Provider Name (Legal Business Name): VEIN CENTRE OF THE PALM BEACHES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2009
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 SANSBURYS WAY SUITE 209
WEST PALM BEACH FL
33411-3624
US

IV. Provider business mailing address

955 SANSBURYS WAY SUITE 209
WEST PALM BEACH FL
33411-3624
US

V. Phone/Fax

Practice location:
  • Phone: 561-333-6366
  • Fax: 561-333-6676
Mailing address:
  • Phone: 561-333-6366
  • Fax: 561-333-6676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberME46520
License Number StateFL

VIII. Authorized Official

Name: DR. ZORAIDA CATHERINE NAVARRO
Title or Position: CEO/OWNER
Credential: M.D.
Phone: 561-333-6366