Organization
NORTHEAST ATLANTA VASCULAR CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
1 DUNWOODY PARK STE 130, ATLANTA, GA 30338-6714
(404) 554-2080
(404) 554-8021
Mailing address
9140 CORSEA DEL FONTANA WAY, NAPLES, FL 34109-4397
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/29/2017
Last updated
02/06/2026
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