Vascular and Embolization Specialists PLLC

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

VASCULAR AND EMBOLIZATION SPECIALISTS PLLC

Practice address

2300 State Road 524 Ste 106
Cocoa, FL 32926-5894

Phone

(321) 321-3001

Fax

(321) 321-4001

NPI assigned

Dec 15, 2023

Organization subpart

No

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

Authorized official

Name

Derek Mittleider, MDNPI 1538234414

Title

Owner

Phone

(207) 749-9036

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Derek Mittleider, M.D.

  • Vascular & Interventional Radiology Physician
  • Cocoa, FL
  • NPI 1538234414
  Medicare reassignment NPD Authorized official
• Christa Joann Lequear, APRN

  • Family Nurse Practitioner
  • Cocoa, FL
  • NPI 1467208777
  NPD

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1629846910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 STATE ROAD 524 STE 106",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329265894",
            "telephone_number": "321-321-3001",
            "fax_number": "321-321-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 STATE ROAD 524 STE 106",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329265894",
            "telephone_number": "321-321-3001",
            "fax_number": "321-321-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR AND EMBOLIZATION SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "MITTLEIDER",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-749-9036",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jennifer Vajanyi, PHARMD
• Michelle Sherry-Ann Vann, FNP
• Anna Varela
• Grace Vaughan
• Terri Lynn Vecchione
• Trina Vega
• Leny De Valle Velasquez, BS, BCABA
• Leslie G Ventura

• Vascular & Interventional Radiology Physician in Cocoa, FL
• Providers in Cocoa, FL by specialty
• Vascular & Interventional Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; 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.