Organization Name: | VEIN SPECIALISTS, P.A. |
NPI Number: | 1043406838 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN M. TIDWELL (PRESIDENT) |
Mailing Address: | 600 Heritage Dr Suite 105 Jupiter |
State: | FL US |
Postal Code: | 334583000 |
Phone Number: | 5616240123 |
Fax Number: | 5616241453 |
NPI Enumeration Date: | 09/14/2007 |
NPI Last Update Date: | 09/14/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0204X |
License Number: | ME 62477 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Vascular & Interventional Radiology |
Taxonomy Definition: | A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |