The Vain Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

ME63493 Issued in FL

Legal business name

THE VAIN CLINIC LLC

Practice address

160 NW Central Park PLZ Ste 104
Port St Lucie, FL 34986-1825

Phone

(772) 871-8922

NPI assigned

Sep 9, 2011

Last updated

Sep 9, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Pamela RobertsNPI 1700893310

Title

Owner

Phone

(772) 871-8922

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pamela Roberts, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fort Pierce, FL
  • NPI 1700893310
  NPD (past) Authorized official

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315526400000",
    "number": "1316229982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 NW CENTRAL PARK PLZ STE 104",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861825",
            "telephone_number": "772-871-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 NW CENTRAL PARK PLZ STE 104",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861825",
            "telephone_number": "772-871-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VAIN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-09",
        "last_updated": "2011-09-09",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-871-8922",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "ME63493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.