Provider Demographics
NPI:1750564696
Name:SUNCOAST VEIN & VASCULAR CLINIC PLC
Entity type:Organization
Organization Name:SUNCOAST VEIN & VASCULAR CLINIC PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SWAPNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGIREDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-235-9677
Mailing Address - Street 1:1728 DUNLAWTON AVE
Mailing Address - Street 2:STE 5
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-2922
Mailing Address - Country:US
Mailing Address - Phone:386-304-3404
Mailing Address - Fax:386-304-3135
Practice Address - Street 1:1728 DUNLAWTON AVE
Practice Address - Street 2:STE 5
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-2922
Practice Address - Country:US
Practice Address - Phone:386-304-3404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME813952085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty