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General NPI Number Information
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NPI Number | 1538018262
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Entity Type | Organization
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Legal Business Name | GULF COAST VEIN AND WOUND CARE SPECIALISTS LLC
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Dates
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Enumeration Date | 01/26/2026
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 2146 VINDALE RD
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City | TAVARES
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State | FL
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Zip | 32778-5602
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Country | US
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Telephone | 352-414-5987
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Fax |
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Provider Business Mailing Address
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Address Line | 13 CROSSANDRA DR
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City | HOMOSASSA
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State | FL
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Zip | 34446-8416
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Country | US
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Telephone | 352-414-5987
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TAMMY PAULLIN
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Credential | ARNP
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Telephone | 904-434-0739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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