# VEIN & AESTHETICS CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467109314
- **Authorized official:** DR. FARIBA GHARAI MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (813) 533-1999

## Contact information

- **Practice address:** 14502 N DALE MABRY HWY STE 103, TAMPA, FL 33618-2076
- **Practice address phone:** (813) 533-1999
- **Practice address fax:** (813) 533-7151
- **Mailing address:** 14502 N DALE MABRY HWY STE 103, TAMPA, FL 33618-2076
- **Mailing address phone:** (813) 533-1999
- **Mailing address fax:** (813) 533-7151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/09/2022
- **Last updated:** 03/09/2022