Provider Demographics
NPI:1912149642
Name:VEIN CENTRE OF THE PALM BEACHES INC
Entity Type:Organization
Organization Name:VEIN CENTRE OF THE PALM BEACHES INC
Other - Org Name:NAVARRO DERMATOLOGY SKIN AND VEIN CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZORAIDA
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-333-6366
Mailing Address - Street 1:955 SANSBURYS WAY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-3624
Mailing Address - Country:US
Mailing Address - Phone:561-333-6366
Mailing Address - Fax:561-333-6676
Practice Address - Street 1:955 SANSBURYS WAY
Practice Address - Street 2:SUITE 209
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3624
Practice Address - Country:US
Practice Address - Phone:561-333-6366
Practice Address - Fax:561-333-6676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
202K00000X
FLME46520261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD65295Medicare UPIN