Dominion Vascular Surgical Specialists

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

DOMINION VASCULAR SURGICAL SPECIALISTS

Practice address

1355 S International Pkwy Ste 1491
Lake Mary, FL 32746-1694

Phone

(040) 754-3641

NPI assigned

Jul 15, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Olubunmi Olatayo Esan, MDNPI 1558795377

Title

Dr.

Phone

(347) 829-0399

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Dominion Vascular Surgical Specialists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dominion Vascular Surgical Specialists

  • Vascular Surgery Physician
  • Lake Mary, FL
  • NPI 1336982644
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olubunmi Olatayo Esan, M.D

  • Vascular Surgery Physician
  • Lake Mary, FL
  • NPI 1558795377
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1134966286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W LAKE MARY BLVD STE 1010",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462449",
            "telephone_number": "347-829-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 S INTERNATIONAL PKWY STE 1491",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461694",
            "telephone_number": "040-754-3641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "917 Rinehart Rd Ste 2041",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327464806",
            "country_code": "US",
            "telephone_number": "347-829-0399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1691 Mayo Dr",
            "address_purpose": "LOCATION",
            "city": "Tavares",
            "state": "FL",
            "postal_code": "327784301",
            "country_code": "US",
            "telephone_number": "040-754-3641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DOMINION VASCULAR SURGICAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "ESAN",
        "authorized_official_first_name": "OLUBUNMI",
        "authorized_official_middle_name": "OLATAYO",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "347-829-0399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dixon and Herring, LLC
• Dna Comprehensive Therapy Services, LLC
• Hannah Dobbelmann
• Micah Dobbins
• Jennifer Marie Doig, MS
• Dominion Vascular Surgical Specialists
• Anabella M Dones, MD
• Shruti Dosi, DPM
• Molly Dowdy, BCBA
• Tyler Christian Downer

• Vascular Surgery Physician in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Vascular Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.