Vein Treatment Center of Palm Coast P a

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

ME39243 Issued in FL

Legal business name

VEIN TREATMENT CENTER OF PALM COAST P A

Practice address

21 Hospital Dr
Suite 260
Palm Coast, FL 32164-2452

Phone

(386) 586-5344

Fax

(386) 586-5450

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nickolas John Collucci, D.O.

Title

President

Phone

(386) 586-5344

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360540800000",
    "number": "1689893224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 279",
            "city": "FLAGLER BEACH",
            "state": "FL",
            "postal_code": "321360279",
            "telephone_number": "386-586-5344",
            "fax_number": "386-586-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HOSPITAL DR",
            "address_2": "SUITE 260",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642452",
            "telephone_number": "386-586-5344",
            "fax_number": "386-586-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN TREATMENT CENTER OF PALM COAST P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2013-02-11",
        "status": "A",
        "authorized_official_last_name": "COLLUCCI",
        "authorized_official_first_name": "NICKOLAS",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-586-5344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": "FL",
            "license": "ME39243",
            "primary": true
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": "FL",
            "license": "OS4153",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS4153",
            "primary": false
        },
        {
            "code": "207VH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME39243",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna S Valvo Schnotalla, RBT
• Kara Lindsay Van Wetering
• Maria Varlashkina, APRN
• Renae Vaughn, RN, MSN, ARNP-C
• Laura Vega
• Teresa K Velez, ARNP
• Amanda Vera, APRN
• Natalya A Verbinskaya, MD
• Vincent G Verdeflor, M.D.
• Daryl Lawrence Vergara, P.T.A.

• Phlebology Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Phlebology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; 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.