Organization
THE VASCULAR CLINIC & COSMETIC VEIN TREATMENT CENTER PL
Active
Other names
Scott R Hannum DO PL
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT R HANNUM DO (PRESIDENT)
(407) 518-4982
Entity
Organization
Contact information
Practice address
720 W OAK ST STE 309, KISSIMMEE, FL 34741-4910
(407) 518-4982
(407) 518-1748
Mailing address
PO BOX 620696, ORLANDO, FL 32862-0696
(407) 518-4982
(407) 518-1748
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
OS8740
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17027
BCBS
FL
05
—
264703600
—
FL
Enumeration date
09/20/2006
Last updated
06/01/2020
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