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NPI Code Detail

MEDICARE: VALERY A. NIEDERMEYER M.D.

MEDICARE: VALERY A. NIEDERMEYER M.D.
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
1207P00000XEmergency Medicine PhysicianK3930TX
2208000000XPediatrics PhysicianK3930TX
3208000000XPediatrics PhysicianME77490FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME77490OTHERFLSTATE LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598799538
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERY A. NIEDERMEYER M.D.
Provider Business Mailing Address
First Line : 1545 9TH ST SW
Second Line :
City : VERO BEACH
State : FL
Zip : 32962-4312
Country : US
Telephone Number : 772-257-8224
Fax Number : 772-213-3157
Provider Business Practice Location Address
First Line : 4675 28TH CT
Second Line :
City : VERO BEACH
State : FL
Zip : 32967-1329
Country : US
Telephone Number : 772-257-8224
Fax Number : 772-213-3157
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 08/14/2019

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