Mark Vandenberg

Specialist · Ft Lauderdale, FL

Individual Active NPI

NPI number 1689890949

Practice location

1601 NE 11TH Ave
Ft Lauderdale, FL 33305-3171
Phone
(920) 850-5758

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NPI record

NPI
1689890949
Entity type
Individual (Type 1)
Enumeration date
April 17, 2007
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Specialist Primary 174400000X PTA20097 FL

About Mark Vandenberg

Mark Vandenberg is a healthcare provider registered in the NPI registry with the primary taxonomy Specialist (code 174400000X). The practice location is 1601 NE 11TH Ave, Ft Lauderdale, FL 33305-3171. The NPI number 1689890949 was assigned on April 17, 2007 and the record was last updated on July 8, 2007.

Mark Vandenberg lists a license in the registry: #PTA20097 (FL) for Specialist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mark Vandenberg?

The NPI number is 1689890949.

What is the phone number of Mark Vandenberg?

The phone number listed for the practice location is (920) 850-5758.

Where is Mark Vandenberg located?

1601 NE 11TH Ave, Ft Lauderdale, FL 33305-3171.

What is the taxonomy code for Mark Vandenberg?

The primary taxonomy code is 174400000X – Specialist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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