Organization Active NPI

Vein & Vascular Experts, PLLC

  • Vascular Surgery Physician
  • Lakeland, FL
National Provider Identifier
1689196248
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME112008 Issued in FL
Legal business name
VEIN & VASCULAR EXPERTS, PLLC
Practice address
5325 US Hwy 98 S
Lakeland, FL 33812
Phone
(863) 937-3139
Fax
(863) 937-3147
NPI assigned
Jul 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Authorized official

Name
Dr. Gustavo De Jesus-Gomez, MDNPI 1033314190
Title
Owner/President
Phone
(863) 937-3139

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
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X ME112008 FL Primary

Addresses

Primary practice location

5325 US Hwy 98 S
Lakeland, FL 33812

Mailing address

PO Box 1328
Highland City, FL 33846-1328
Phone (863) 937-3139

Other practice location 1

1601 W Timberlane Dr Ste 600
Plant City, FL 33566-0958
Phone (863) 937-3139

Other practice location 2

202 Howard St Ste 2
Auburndale, FL 33823-3431
Phone (863) 937-3139

Other identifiers 1

IdentifierTypeStateIssuer
113603200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171218000841 FL Part B Supplier - Clinic/Group Practice 7618235839 Receives reassigned benefits from 5 practitioners
Practice locations: Lakeland, FL

National Provider Directory

National Provider Directory

Locations

5907 Hillside Heights Dr
Lakeland, FL 33812
Phone (863) 647-2200

Practitioners & affiliated clinicians

Practitioners 6

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": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1689196248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1328",
            "city": "HIGHLAND CITY",
            "state": "FL",
            "postal_code": "338461328",
            "telephone_number": "863-937-3139",
            "fax_number": "863-937-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 US HWY 98 S",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33812",
            "telephone_number": "863-937-3139",
            "fax_number": "863-937-3147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 W Timberlane Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Plant City",
            "state": "FL",
            "postal_code": "335660958",
            "country_code": "US",
            "telephone_number": "863-937-3139",
            "fax_number": "863-937-3147",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 Howard St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Auburndale",
            "state": "FL",
            "postal_code": "338233431",
            "country_code": "US",
            "telephone_number": "863-937-3139",
            "fax_number": "863-937-3147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VEIN & VASCULAR EXPERTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-14",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "DE JESUS-GOMEZ",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "863-937-3139",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME112008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113603200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.