Individual
ROBERT VANDERLEEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E BROWARD BLVD, SUITE 507, FORT LAUDERDALE, FL 33301-2008
(954) 763-4331
Mailing address
800 CREEK DR, MENLO PARK, CA 94025-5317
(650) 324-9135
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G46075
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G460750
—
CA
Enumeration date
10/25/2006
Last updated
01/15/2014
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