Organization
VSN MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURYA RAO MD (OWNER)
(386) 423-0505
Entity
Organization
Contact information
Practice address
1055 N DIXIE FREEWAY, SUITE 1, NEW SMYRNA BEACH, FL 32168-6200
(386) 423-0505
(386) 423-0515
Mailing address
1055 N DIXIE FREEWAY, SUITE 1, NEW SMYRNA BEACH, FL 32168-6200
(386) 423-0505
(386) 423-0515
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME96830
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94219
BLUE CROSS OF FLORIDA
FL
Enumeration date
01/15/2013
Last updated
01/15/2013
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