Provider Demographics
NPI:1174117865
Name:VEIN AND VASCULAR CONSULTANTS LLC
Entity type:Organization
Organization Name:VEIN AND VASCULAR CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:LANDON
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:RDCS, RVT, RPHS
Authorized Official - Phone:301-801-8800
Mailing Address - Street 1:4067 CRYSTAL LAKE DR
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-1255
Mailing Address - Country:US
Mailing Address - Phone:301-801-8800
Mailing Address - Fax:
Practice Address - Street 1:4067 CRYSTAL LAKE DR
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-1255
Practice Address - Country:US
Practice Address - Phone:301-801-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular SpecialistGroup - Multi-Specialty