Organization
COLORADO MEDICAL GROUP, PLLC
Active
Other names
United Vein & Vascular Centers
Organization subpart
No
Provider details
NPI number
Authorized official
ALI N WAZNI MD (CHIEF MEDICAL OFFICER)
(518) 817-1747
Entity
Organization
Contact information
Practice address
1551 PROFESSIONAL LN UNIT 240, LONGMONT, CO 80501-6967
(800) 991-6117
Mailing address
3810 NORTHDALE BLVD STE 150, TAMPA, FL 33624-1871
(813) 321-4906
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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