Provider Demographics
NPI:1396491064
Name:THAT'S SO VEIN
Entity type:Organization
Organization Name:THAT'S SO VEIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-805-7021
Mailing Address - Street 1:3425 BAYSIDE LAKES BLVD SE STE 103
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-6867
Mailing Address - Country:US
Mailing Address - Phone:321-730-2091
Mailing Address - Fax:321-522-0114
Practice Address - Street 1:3425 BAYSIDE LAKES BLVD SE STE 103
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-6867
Practice Address - Country:US
Practice Address - Phone:321-730-2091
Practice Address - Fax:321-522-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty