Healthcare Provider Details

I. General information

NPI: 1184626079
Provider Name (Legal Business Name): VERO ORTHOPAEDICS II PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 03/18/2024
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3955 INDIAN RIVER BLVD STE 100
VERO BEACH FL
32960-4845
US

IV. Provider business mailing address

3955 INDIAN RIVER BLVD STE 100
VERO BEACH FL
32960-4845
US

V. Phone/Fax

Practice location:
  • Phone: 772-569-2330
  • Fax: 772-569-2630
Mailing address:
  • Phone: 772-569-2330
  • Fax: 772-569-2630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN P PEDEN
Title or Position: PRESIDENT
Credential: MD
Phone: 772-569-2330