| Mountcastle Vein Center Of St Petersburg | |
|
5901 Sun Blvd Suite 113a St Petersburg FL 33715-1166 | |
| (727) 865-6941 | |
| (727) 864-0929 |
| Full Name | Mountcastle Vein Center Of St Petersburg |
|---|---|
| Speciality | General Practice |
| Location | 5901 Sun Blvd, St Petersburg, Florida |
| Authorized Official Name and Position | Daniel J Mountcastle (PRESIDENT) |
| Authorized Official Contact | 7278656941 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountcastle Vein Center Of St Petersburg 5901 Sun Blvd Suite 201 St Petersburg FL 33715-1166 Ph: (727) 865-6941 | Mountcastle Vein Center Of St Petersburg 5901 Sun Blvd Suite 113a St Petersburg FL 33715-1166 Ph: (727) 865-6941 |
| NPI Number | 1619022951 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 11/20/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619022951 | NPI | - | NPPES |
| 3027OT | Other | FL | MEDICARE |
| 039342800 | Medicaid | FL | |
| ME36289 | Other | FL | MEDICAL LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ME36289 (Florida) | Primary |
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