Individual
DR. DONALD HENRY VLIEGENTHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
709 S. HARBOR CITY BOULEVARD, SUITE 100, MELBOURNE, FL 32901-1936
(321) 725-2225
(321) 308-0635
Mailing address
709 S. HARBOR CITY BOULEVARD, SUITE 100, MELBOURNE, FL 32901-1936
(321) 725-2225
(321) 308-0635
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
ME36928
FL
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
ME36928
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26612
BCBS OF FL
FL
Enumeration date
01/05/2007
Last updated
06/16/2014
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