Organization
ALL VEIN CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY SMITH BSM (OFFICE MANAGER)
(941) 613-3773
Entity
Organization
Contact information
Practice address
2525 HARBOR BLVD, SUITE 202, PORT CHARLOTTE, FL 33952-5317
(941) 766-8346
(941) 629-6770
Mailing address
2525 HARBOR BLVD, SUITE 202, PORT CHARLOTTE, FL 33952-5317
(941) 766-8346
(941) 629-6770
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME0040565
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08118
COMMERCIAL
FL
Enumeration date
06/16/2006
Last updated
02/02/2010
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