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NPI Code Detail

MEDICARE: VEIN SPECIALISTS AT ROYAL PALM SQUARE INC

MEDICARE: VEIN SPECIALISTS AT ROYAL PALM SQUARE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0129XVascular Surgery PhysicianME94904FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11588682728OTHERFLNPI

General Provider Information

NPI Number : 1124205349
Entity Type Code : Organization
Provider Name (Legal Business Name) : VEIN SPECIALISTS AT ROYAL PALM SQUARE INC
Provider Business Mailing Address
First Line : 1510 ROYAL PALM SQUARE BLVD
Second Line : STE. 101
City : FORT MYERS
State : FL
Zip : 33919-1068
Country : US
Telephone Number : 239-694-8346
Fax Number : 239-936-6272
Provider Business Practice Location Address
First Line : 1510 ROYAL PALM SQUARE BLVD
Second Line : STE. 101
City : FORT MYERS
State : FL
Zip : 33919-1068
Country : US
Telephone Number : 239-694-8346
Fax Number : 239-936-6272
Authorized Official
Title or Position : M.D.
Name : DR. JOSEPH GEORGE MAGNANT
Credential : M.D.
Telephone Number : 239-694-8346
Provider Enumeration Date : 01/30/2008
Last Update Date : 10/01/2008

Similar Medicare Providers

1558353748 — ROBIN THAD GOODWIN M.D.
Practice Location Address:
1510 ROYAL PALM SQUARE BLVD , STE 106
FORT MYERS, FL
33919-1068
Practice Phone: 239-939-3937
Practice Fax: 239-275-8045
1588682728 — DR. JOSEPH G MAGNANT M.D.
Practice Location Address:
1510 ROYAL PALM SQUARE BLVD , SUITE 101
FORT MYERS, FL
33919-1068
Practice Phone: 239-694-8346
Practice Fax: 239-936-6272
1780891424 — HEALTHSPOT PHYSICAL THERAPY & FITNESS, INC
Practice Location Address:
1510 ROYAL PALM SQUARE BLVD , SUITE 105
FORT MYERS, FL
33919-1068
Practice Phone: 239-274-7008
Practice Fax: 239-274-7070
1285813410 — R THAD GOODWIN MD PA
Practice Location Address:
1510 ROYAL PALM SQUARE BLVD , STE 106
FORT MYERS, FL
33919-1068
Practice Phone: 239-939-3937
Practice Fax: 239-275-8045
1871807420 — ROBERT M MANDELKORN, M.D., INC.
Practice Location Address:
1510 ROYAL PALM SQUARE BLVD , STE 106
FORT MYERS, FL
33919-1068
Practice Phone: 239-939-3937
Practice Fax: 239-275-8045
1134877244 — ANDREA BUSBEE PA-C
Practice Location Address:
1510 ROYAL PALM SQUARE BLVD STE 105
FORT MYERS, FL
33919-1068
Practice Phone: 239-245-8899
Practice Fax:

Directions to “VEIN SPECIALISTS AT ROYAL PALM SQUARE INC ” Practice Location

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