Individual
DR. VIVIANA G. COLMEGNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3000 41ST STREET OCEAN, MARATHON, FL 33050-2373
(305) 434-9033
Mailing address
3000 41ST STREET OCEAN, MARATHON, FL 33050-2373
(305) 434-9033
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME74788
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265062200
—
FL
01
—
44952
BLUE SHIELD OF FL
FL
Enumeration date
06/23/2006
Last updated
08/02/2008
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