Provider Demographics
NPI:1275016941
Name:VASCULAR AND VEIN INSTITUTE OF THE SOUTH, PLLC
Entity Type:Organization
Organization Name:VASCULAR AND VEIN INSTITUTE OF THE SOUTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FILER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-390-2930
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33425-0386
Mailing Address - Country:US
Mailing Address - Phone:561-312-1082
Mailing Address - Fax:800-783-5123
Practice Address - Street 1:1385 W BRIERBROOK RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2208
Practice Address - Country:US
Practice Address - Phone:561-312-1082
Practice Address - Fax:800-783-5123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty