Organization Name:  VESC INC


Practice Location:
550 MEMORIAL CIR SUITE G ORMOND BEACH, FL 32174 US
Tel: 386-672-0017  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	261QA1903X	Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical	FL	786

Other Provider Identifiers:

Issuer	Number	State	Type
	079123700	FL	05
BLUE CROSS BLUE SHIELD FL	63F	FL	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin