Provider Demographics
NPI:1912312497
Name:VIERA HEART AND VASCULAR CLINIC LLC
Entity type:Organization
Organization Name:VIERA HEART AND VASCULAR CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HONG
Authorized Official - Middle Name:SUN
Authorized Official - Last Name:JEONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-677-8956
Mailing Address - Street 1:8095 SPYGLASS HILL RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8290
Mailing Address - Country:US
Mailing Address - Phone:804-677-8956
Mailing Address - Fax:
Practice Address - Street 1:3361 THURLOE DR
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-6063
Practice Address - Country:US
Practice Address - Phone:804-677-8956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-24
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty