Provider Demographics
NPI:1205251410
Name:VERO MEDICAL SPECIALISTS, INC.
Entity type:Organization
Organization Name:VERO MEDICAL SPECIALISTS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCRIVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-360-4249
Mailing Address - Street 1:787 37TH ST
Mailing Address - Street 2:SUITE E170
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-7305
Mailing Address - Country:US
Mailing Address - Phone:772-360-4249
Mailing Address - Fax:772-365-2404
Practice Address - Street 1:787 37TH ST
Practice Address - Street 2:SUITE E170
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-7305
Practice Address - Country:US
Practice Address - Phone:772-360-4249
Practice Address - Fax:772-365-2404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105905207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty