MARK VANDENBERG (NPI# 1689890949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689890949 |
| Entity Type | Individual |
| Full Name | MARK VANDENBERG |
| Practice Address |
1601 Ne 11th Ave Ft Lauderdale FL 33305-3171 |
| Practice Telephone | 9208505758 |
| Mailing Telephone | 9208505758 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | PTA20097 | FL | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275752834 | Mark Randal Vandenberg | Dentist | 5801 W Britton Rd Ste B, Oklahoma City, OK 73132-2404 | 2007-04-24 |
| 1669454807 | Mark Thomas Vandenberg | Surgery | 1215 Duff Ave, Ames, IA 50010-3014 | 2005-11-15 |
| Street Address |
1601 NE 11TH AVE |
| City | FT LAUDERDALE |
| State | FL |
| Zip Code | 33305-3171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982244331 | Michael Moses Gans | Social Worker | 520 Ne 20th Street, #603, Wilton Manors, FL 33305 | 2020-01-14 |
| 1922650159 | Samantha Jones | Chiropractor | 1732 Ne 26th St Ste 201, Wilton Manors, FL 33305 | 2019-07-09 |
| 1033601653 | Neuro Intergration LLC | Psychologist | 2500 N Federal Hwy Ste 100, Fort Lauderdale, FL 33305 | 2018-05-30 |
| 1548775000 | Inbox Inc. | Counselor | 1650 Ne 26th St., Suite 206, Wilton Manors, FL 33305 | 2017-12-06 |
| 1306394168 | The 5 Elements Spa & Longevity Center | Health Maintenance Organization | 2288 Wilton Drive, Wilton Manors, FL 33305 | 2016-09-21 |
| 1467900449 | Crystal L Cacolici | Acupuncturist | 1732 Ne 26th St Ste 202, Wilton Manors, FL 33305 | 2016-09-19 |
| 1649634809 | Terri-ann Brown Arnp | Nurse Practitioner | 1881 Ne 26th Street, Suite 102, Fort Lauderdale, FL 33305 | 2016-04-13 |
| 1194130203 | Rhea Butchey | Optometrist | 2131 N Federal Hwy, Fort Lauderdale, FL 33305 | 2014-06-26 |
| 1891128732 | Ashton Pierce Thompson | Internal Medicine | 2449 Ne 13th Ave, Wilton Manors, FL 33305 | 2013-08-14 |
| 1427300789 | Kids In Distress | Foster Care Agency | 819 Ne 26th St., Ft. Laud, FL 33305 | 2012-10-11 |
| Find all providers in zip 33305 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972888634 | Choice Orthopedics | Specialist | 2419 E Commercial Blvd, Suite# 101, Ft Lauderdale, FL 33308-4042 | 2011-10-13 |
| 1043462799 | Performance Orthopaedic | Specialist | 721 Se 17th St, #104, Ft Lauderdale, FL 33316-2983 | 2008-10-14 |
| 1538310669 | Sharon Gerthoffer | Specialist | 1140 Se3rd Ave, Ft Lauderdale, FL 33316 | 2008-10-07 |
| 1508046913 | Zoran Potparic, M.d., P.a. | Specialist | 1116 East Broward Blvd, Ft Lauderdale, FL 33301 | 2007-11-14 |
| 1568581502 | Meli Orthopedic Centers of Excellence,llc. | Specialist | 4800 Ne 20th Ter Ste 303, Ft Lauderdale, FL 33308 | 2007-03-29 |
| 1871635300 | Linda G Vega | Specialist | 3324 Ne 33rd St, Ft Lauderdale, FL 33308-7110 | 2007-02-12 |
| 1770624546 | Usa Mobile Diagnostic, Inc. | Specialist | 4021 N Andrews Ave Ste 6, Ft Lauderdale, FL 33309-5297 | 2007-02-12 |
| 1356417372 | Nancy M Adam | Specialist | 1750 Nw 3rd Ter, #102c, Ft Lauderdale, FL 33311-4884 | 2006-11-28 |
| 1366527749 | Paul James Glusman | Specialist | 5230 Ne 26th Ave, Ft Lauderdale, FL 33308-3306 | 2006-10-26 |
| 1164513958 | Martin M. Roche Sr. | Specialist | 103 Se 20th St, Ft Lauderdale, FL 33316-2846 | 2006-09-27 |
| Find all providers in FT LAUDERDALE | ||||
| City | FT LAUDERDALE |
| Zip Code | 33305 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.