Provider Demographics
NPI:1932578481
Name:VERO COSMETIC SURGERY & MEDISPA LLC
Entity Type:Organization
Organization Name:VERO COSMETIC SURGERY & MEDISPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:FRAZIER M.D.
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-562-2400
Mailing Address - Street 1:1255 37TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6550
Mailing Address - Country:US
Mailing Address - Phone:772-562-2400
Mailing Address - Fax:772-569-3208
Practice Address - Street 1:1255 37TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6550
Practice Address - Country:US
Practice Address - Phone:772-562-2400
Practice Address - Fax:772-569-3208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and NeckGroup - Multi-Specialty