Organization
COSMETIC VEIN CLINIC OF FLORIDA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH P PECORARO MD (OWNER)
(941) 761-1746
Entity
Organization
Contact information
Practice address
2225 59TH ST W, SUITE B, BRADENTON, FL 34209-7017
(941) 761-1746
(941) 761-0188
Mailing address
2225 59TH ST W, SUITE B, BRADENTON, FL 34209-7017
(941) 761-1746
(941) 761-0188
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME59036
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263214400
—
FL
Enumeration date
01/30/2009
Last updated
02/25/2009
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