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General NPI Number Information
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NPI Number | 1689917445
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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 | 03/30/2013
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Last Update Date | 03/30/2013
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Provider Practice Location Address
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Address Line | 40107 HIGHWAY 27
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City | DAVENPORT
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State | FL
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Zip | 33837-5901
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Country | US
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Telephone | 863-701-4808
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Fax |
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Provider Business Mailing Address
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Address Line | 5001 LATROBE DR
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City | WINDERMERE
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State | FL
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Zip | 34786-8914
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Country | US
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Telephone |
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Fax |
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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 |
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