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General NPI Number Information
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NPI Number | 1720075658
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Entity Type | Individual
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Provider Name | JAMES P VANGELDER M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 3700 WASHINGTON ST SUITE 500
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8259
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Country | US
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Telephone | 954-962-0338
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Fax | 954-962-2357
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Provider Business Mailing Address
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Address Line | 3700 WASHINGTON ST SUITE 500
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8259
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Country | US
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Telephone | 954-962-0338
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Fax | 954-962-2357
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME22201
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License Number State | FL
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