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General NPI Number Information
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NPI Number | 1467795286
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Entity Type | Organization
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Legal Business Name | FLORIDA VEIN CARE SPECIALISTS, LLC
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 201 N LAKEMONT AVE STE 700
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City | WINTER PARK
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State | FL
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Zip | 32792-3228
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Country | US
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Telephone | 321-252-0327
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Fax | 863-215-7085
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Provider Business Mailing Address
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Address Line | PO BOX 12571
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City | BELFAST
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State | ME
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Zip | 04915-4016
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Country | US
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Telephone | 321-252-0327
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Fax | 863-215-7085
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER G MEYER
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Credential | M.D
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Telephone | 863-701-4808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | ME90559
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License Number State | FL
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