Provider Demographics
NPI:1407380017
Name:CINCINNATI VEIN CARE SPECIALISTS, INC
Entity Type:Organization
Organization Name:CINCINNATI VEIN CARE SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-701-4808
Mailing Address - Street 1:2955 PINEDA PLAZA WAY
Mailing Address - Street 2:SUITE 121
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7318
Mailing Address - Country:US
Mailing Address - Phone:321-252-0327
Mailing Address - Fax:863-215-7085
Practice Address - Street 1:11123 MONTGOMERY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2389
Practice Address - Country:US
Practice Address - Phone:513-401-8485
Practice Address - Fax:863-215-7085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.129976174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty