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Individual

DR. JOHN PATRICK PEDEN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3955 INDIAN RIVER BLVD STE 100, VERO BEACH, FL 32960-4800
(772) 569-2330
(772) 569-2630
Mailing address
3955 INDIAN RIVER BLVD STE 100, VERO BEACH, FL 32960-4800
(772) 569-2330
(772) 569-2630

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
ME96237
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
56369
BC BS PROVIDER NUMBER
FL
Enumeration date
10/12/2005
Last updated
08/11/2021
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