MEDICARE: DR. DENISE VILCHEZ CARDENAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ME133568	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164861977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENISE VILCHEZ CARDENAL MD

Provider Business Mailing Address
First Line	:	12554 SW KEY DEER LN
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34987-6408
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1210 S OLD DIXIE HWY
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-7205
Country	:	US
Telephone Number	:	561-263-2234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2013
Last Update Date	:	03/12/2026

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