Organization
SUNCOAST VASCULAR CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC J GOULET MD (CEO)
(954) 439-3465
Entity
Organization
Contact information
Practice address
3722 CENTRAL AVE, SUITE 6, FT MYERS, FL 33901-8247
(239) 277-7700
(239) 277-7070
Mailing address
840 US HIGHWAY ONE #210, ATTN AMBER KENNEDY, NORTH PALM BEACH, FL 33408-3830
(561) 626-9021
(561) 626-7593
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50648
BC BS
FL
Enumeration date
11/27/2006
Last updated
08/22/2020
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