Organization
THE VAIN CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA ROBERTS (OWNER)
(772) 871-8922
Entity
Organization
Contact information
Practice address
160 NW CENTRAL PARK PLZ STE 104, PORT ST LUCIE, FL 34986-1825
(772) 871-8922
Mailing address
160 NW CENTRAL PARK PLZ STE 104, PORT ST LUCIE, FL 34986-1825
(772) 871-8922
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
ME63493
FL
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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