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General NPI Number Information
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NPI Number | 1639414618
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Entity Type | Organization
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Legal Business Name | GULF COAST VEIN CENTER, P.A.
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Dates
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Enumeration Date | 12/03/2012
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Last Update Date | 07/22/2013
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Provider Practice Location Address
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Address Line | 4900 95TH AVE N
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City | PINELLAS PARK
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State | FL
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Zip | 33782-3544
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Country | US
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Telephone | 727-623-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 95TH AVE N
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City | PINELLAS PARK
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State | FL
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Zip | 33782-3544
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Country | US
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Telephone | 727-623-9999
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM D BOWERS
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Credential | MD
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Telephone | 727-623-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number |
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License Number State |
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