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General NPI Number Information
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NPI Number | 1174117865
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Entity Type | Organization
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Legal Business Name | VEIN AND VASCULAR CONSULTANTS LLC
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 02/24/2021
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Provider Practice Location Address
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Address Line | 4067 CRYSTAL LAKE DR
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City | DEERFIELD BEACH
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State | FL
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Zip | 33064-1255
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Country | US
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Telephone | 301-801-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 4067 CRYSTAL LAKE DR
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City | DEERFIELD BEACH
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State | FL
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Zip | 33064-1255
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Country | US
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Telephone | 301-801-8800
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Fax |
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Authorized Official
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Title or Position | CLINICAL COORDINATOR
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Name | MR. JOHN LANDON CARTER
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Credential | RDCS, RVT, RPHS
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Telephone | 301-801-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XC2903X
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Taxonomy Name | Vascular Specialist/Technologist Cardiovascular
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License Number |
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License Number State |
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