MEDICARE: VEINCARE PROCESSING LLC

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
1	291U00000X	Clinical Medical Laboratory		FL

General Provider Information

NPI Number	:	1538479167
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VEINCARE PROCESSING LLC

Provider Business Mailing Address
First Line	:	2110 HUNTLEIGH POINTE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-5938
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 HUNTLEIGH POINTE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-5938
Country	:	US
Telephone Number	:	305-491-3809
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MR. CHEVERAL DEACON
Credential	:	ASPT
Telephone Number	:	305-491-3809

Provider Enumeration Date	:	10/18/2010
Last Update Date	:	10/18/2010

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Directions to “VEINCARE PROCESSING LLC ” Practice Location

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