Healthcare Provider Details

I. General information

NPI: 1700923190
Provider Name (Legal Business Name): FACE CENTER OF VERO PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 36TH ST SUITE A
VERO BEACH FL
32960-6599
US

IV. Provider business mailing address

1325 36TH ST SUITE A
VERO BEACH FL
32960-6599
US

V. Phone/Fax

Practice location:
  • Phone: 772-567-1165
  • Fax: 772-770-0799
Mailing address:
  • Phone: 772-567-1165
  • Fax: 772-770-0799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberME0064734
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberME0064734
License Number StateFL

VIII. Authorized Official

Name: DR. DONALD C PROCTOR
Title or Position: PRESIDENT
Credential: MD
Phone: 772-567-1165