NPIMap

Organization Active NPI

Vein Associates, PA

  • Phlebology Physician
  • Heathrow, FL
National Provider Identifier
1326076902
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
Legal business name
VEIN ASSOCIATES, PA
Practice address
400 International Pkwy
Suite 100
Heathrow, FL 32746-5061
Phone
(803) 808-8070
Fax
(803) 808-8074
NPI assigned
Jun 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Authorized official

Name
Dr. Robert James Theobald III, DONPI 1396778239
Title
Physician
Phone
(803) 808-8070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 202K00000X Primary

Addresses

Primary practice location

400 International Pkwy
Suite 100
Heathrow, FL 32746-5061

Mailing address

PO Box 863550
Orlando, FL 32886-3550
Phone (803) 808-8070

Other identifiers 2

IdentifierTypeStateIssuer
97985OtherFLBCBS GROUP NUMBER
53M96REOtherMNBCBS GROUP NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Vein Associates PA2 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.

Locations

6001 Vineland Rd
Ste 104
Orlando, FL 32819
Phone (407) 574-5650

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1326076902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863550",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863550",
            "telephone_number": "803-808-8070",
            "fax_number": "803-808-8074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL PKWY",
            "address_2": "SUITE 100",
            "city": "HEATHROW",
            "state": "FL",
            "postal_code": "327465061",
            "telephone_number": "803-808-8070",
            "fax_number": "803-808-8074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "THEOBALD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "803-808-8070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "97985",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "53M96RE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Heathrow, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.