Organization · NPI-2

Coastal Vein And Vascular Specialists, INC

· Palm Beach Gardens, FL

NPI number1497238091

StatusActive

Last updated in NPPESJun 9, 2020

Details

NPI: 1497238091
Entity type: Organization (NPI-2)
Legal business name: Coastal Vein And Vascular Specialists, INC
Organization subpart: No
Enumeration date: Sep 10, 2018
Certification date: Jun 9, 2020
Last updated: Jun 9, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2086S0129X		–	–	Yes

Practice location

3401 Pga Blvd Ste 325
Palm Beach Gardens, FL 33410-2898

Phone 718-974-9494

Mailing address

3401 Pga Blvd Ste 325
Palm Beach Gardens, FL 33410-2898

Phone 561-295-4110

Authorized official

Christopher William Boyes
President And Ceo
5612954110

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