# VVC VIERA LLC

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

## Provider details

- **NPI number:** 1891243051
- **Authorized official:** SAMUEL MARTIN MD (OWNER/MD)
- **Authorized official phone:** (407) 244-8559

## Contact information

- **Practice address:** 1200 EDGEWATER DR, ORLANDO, FL 32804-6314
- **Practice address phone:** (407) 244-8559
- **Mailing address:** 6525 3RD ST, SUITE 208, ROCKLEDGE, FL 32955-5727

## Taxonomy

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

## Other

- **Enumeration date:** 09/16/2016
- **Last updated:** 09/16/2016