Provider Demographics
NPI:1386343028
Name:ARIA VEIN CENTER LLC
Entity type:Organization
Organization Name:ARIA VEIN CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOSHREF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:901-219-3557
Mailing Address - Street 1:PO BOX 10342
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33679-0342
Mailing Address - Country:US
Mailing Address - Phone:901-219-3557
Mailing Address - Fax:
Practice Address - Street 1:4555 S MANHATTAN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-2305
Practice Address - Country:US
Practice Address - Phone:901-219-3557
Practice Address - Fax:321-280-2479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Multi-Specialty