Provider Demographics
NPI:1184180739
Name:LUMIERE COSMETIC VEIN CENTER P A
Entity Type:Organization
Organization Name:LUMIERE COSMETIC VEIN CENTER P A
Other - Org Name:LUMIERE COSMETIC VEIN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:CIPRIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:239-317-0333
Mailing Address - Street 1:2546 HEYDON LN STE 2
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-3550
Mailing Address - Country:US
Mailing Address - Phone:239-317-0333
Mailing Address - Fax:855-574-2200
Practice Address - Street 1:2546 HEYDON LN STE 2
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-3550
Practice Address - Country:US
Practice Address - Phone:954-732-6728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Multi-Specialty