Healthcare Provider Details

I. General information

NPI: 1053611251
Provider Name (Legal Business Name): ROGER R. VERNO, D.C.P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2010
Last Update Date: 10/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 N AUSTRALIAN AVE STE 100
WEST PALM BEACH FL
33407-5626
US

IV. Provider business mailing address

2620 N AUSTRALIAN AVE STE 100
WEST PALM BEACH FL
33407-5626
US

V. Phone/Fax

Practice location:
  • Phone: 561-835-0109
  • Fax: 561-847-4496
Mailing address:
  • Phone: 561-835-0109
  • Fax: 561-847-4496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ROGER ROBERT VERNO
Title or Position: OWNER
Credential: D.C.
Phone: 954-325-7168