# VASCULAR CENTER OF ORLANDO, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vascular Centers of Orlando
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255331666
- **Authorized official:** SAMUEL PRESTON MARTIN IV M.D. (OWNER)
- **Authorized official phone:** (407) 244-8559

## Contact information

- **Practice address:** 1200 EDGEWATER DR, ORLANDO, FL 32804-6314
- **Practice address phone:** (407) 244-8559
- **Practice address fax:** (407) 244-8560
- **Mailing address:** 1200 EDGEWATER DR, ORLANDO, FL 32804-6314
- **Mailing address phone:** (407) 244-8559
- **Mailing address fax:** (407) 244-8560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | ME31846 | FL | Yes |

## Other

- **Enumeration date:** 07/28/2005
- **Last updated:** 10/10/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 037049500 | — | FL |
| 01 | — | 060065287 | CHAMPUS | FL |