Organization
VVC VIERA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL MARTIN MD (OWNER/MD)
(407) 244-8559
Entity
Organization
Contact information
Practice address
1200 EDGEWATER DR, ORLANDO, FL 32804-6314
(407) 244-8559
Mailing address
6525 3RD ST, SUITE 208, ROCKLEDGE, FL 32955-5727
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME31846
FL
Other
Enumeration date
09/16/2016
Last updated
09/16/2016
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