Provider Demographics
NPI:1760871735
Name:MEDICAL VEIN CENTER
Entity Type:Organization
Organization Name:MEDICAL VEIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCEE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRODY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:407-839-0096
Mailing Address - Street 1:1802 KUHL AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2004
Mailing Address - Country:US
Mailing Address - Phone:407-839-0096
Mailing Address - Fax:407-839-0096
Practice Address - Street 1:1802 KUHL AVE STE 103
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2004
Practice Address - Country:US
Practice Address - Phone:407-839-0096
Practice Address - Fax:407-839-0096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005776208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty