| Palm Vein Center Llc | |
|
16944 W Bell Rd #603 Surprise AZ 85374-8950 | |
| (623) 201-4777 | |
| (623) 201-4770 |
| Full Name | Palm Vein Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 16944 W Bell Rd, Surprise, Arizona |
| Authorized Official Name and Position | Jimmy H Dragon (CEO) |
| Authorized Official Contact | 6232014777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palm Vein Center Llc 16944 W Bell Rd Suite 603 Surprise AZ 85374-8950 Ph: (623) 201-4777 | Palm Vein Center Llc 16944 W Bell Rd #603 Surprise AZ 85374-8950 Ph: (623) 201-4777 |
| NPI Number | 1437401106 |
|---|---|
| Provider Enumeration Date | 10/05/2012 |
| Last Update Date | 07/17/2013 |
| Medicare PECOS PAC ID | 8921245556 |
|---|---|
| Medicare Enrollment ID | O20130518000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437401106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Daniel Para |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205830684 PECOS PAC ID: 0042103152 Enrollment ID: I20040203001027 |
| Provider Name | Stephen J Joyce |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1619043890 PECOS PAC ID: 3274553946 Enrollment ID: I20051128000481 |
| Provider Name | Ellaina E Johnson Antes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851780001 PECOS PAC ID: 2163741216 Enrollment ID: I20150512001504 |
| Provider Name | Robert Azizi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316101298 PECOS PAC ID: 3779872981 Enrollment ID: I20191126002686 |
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