The Vascular Clinic & Cosmetic Vein Treatment Center PL

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

OS8740 Issued in FL

Legal business name

THE VASCULAR CLINIC & COSMETIC VEIN TREATMENT CENTER PL

Practice address

720 W Oak St Ste 309
Kissimmee, FL 34741-4910

Phone

(407) 518-4982

Fax

(407) 518-1748

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Scott R Hannum, DONPI 1679595615

Title

President

Phone

(407) 518-4982

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Scott R Hannum DO PL Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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

• Scott R Hannum, DO

  • Vascular Surgery Physician
  • Kissimmee, FL
  • NPI 1679595615
  Medicare reassignment Care Compare group NPD Authorized official
• Jorge Antonio Larranaga, MD

  • Nephrology Physician
  • Kissimmee, FL
  • NPI 1346215308
  Medicare reassignment Care Compare group NPD
• Tri Tu Tran, PA-C

  • Surgical Physician Assistant
  • The Villages, FL
  • NPI 1780658500
  Medicare reassignment

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1356448534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 620696",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328620696",
            "telephone_number": "407-518-4982",
            "fax_number": "407-518-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W OAK ST STE 309",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414910",
            "telephone_number": "407-518-4982",
            "fax_number": "407-518-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VASCULAR CLINIC & COSMETIC VEIN TREATMENT CENTER PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "HANNUM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-518-4982",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "OS8740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "17027",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264703600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scott R Hannum DO PL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Vascular Surgery Physician in Kissimmee, FL
• Providers in Kissimmee, 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 Jun 1, 2020; 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.