Suncoast Vascular Clinic

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SUNCOAST VASCULAR CLINIC

Practice address

3722 Central Ave
Suite 6
Ft Myers, FL 33901-8247

Phone

(239) 277-7700

Fax

(239) 277-7070

NPI assigned

Nov 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Marc J Goulet, MD

Title

Ceo

Phone

(954) 439-3465

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164598678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 US HIGHWAY ONE #210",
            "address_2": "ATTN AMBER KENNEDY",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334083830",
            "telephone_number": "561-626-9021",
            "fax_number": "561-626-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3722 CENTRAL AVE",
            "address_2": "SUITE 6",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339018247",
            "telephone_number": "239-277-7700",
            "fax_number": "239-277-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST VASCULAR CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOULET",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-439-3465",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "50648",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sun Coast Surgical Suites LLC
• Sunburst Cardiology LLC
• Suncoast Injury Centers LLC
• Suncoast Integrated Medical Center LLC
• Suncoast Surgery Center, LLC
• Sunevision LLC
• Dorita Sungailaite
• Sunhealth Medical & Rehabilitation Center
• Sunil Malkani MD PA
• Sunil N Lalla MD PA

• General Practice Physician in Ft Myers, FL
• Providers in Ft Myers, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.