Provider Demographics
NPI:1306104336
Name:THE VASCULAR GROUP OF BRADENTON, P.L.
Entity type:Organization
Organization Name:THE VASCULAR GROUP OF BRADENTON, P.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WOODROW
Authorized Official - Middle Name:W
Authorized Official - Last Name:YEANEY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:813-286-0033
Mailing Address - Street 1:PO BOX 25317
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-5317
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-489-2537
Practice Address - Street 1:4502 CORTEZ RD W
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3143
Practice Address - Country:US
Practice Address - Phone:813-286-0033
Practice Address - Fax:813-489-2537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty