Provider Demographics
NPI:1396921995
Name:VEIN ASSOCIATES, P.A.
Entity type:Organization
Organization Name:VEIN ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAURIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-708-5818
Mailing Address - Street 1:400 INTERNATIONAL PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5061
Mailing Address - Country:US
Mailing Address - Phone:407-708-5818
Mailing Address - Fax:407-708-5819
Practice Address - Street 1:4106 W LAKE MARY BLVD
Practice Address - Street 2:SUITE 325
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3315
Practice Address - Country:US
Practice Address - Phone:407-708-5818
Practice Address - Fax:407-708-5819
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VEIN ASSOCIATES OF AMERICA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38217202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty