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Individual

HENRY C VELDENZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
511 MEDICAL PLAZA DR STE 101, LEESBURG, FL 34748-7328
(352) 728-6808
(352) 728-1743
Mailing address
511 MEDICAL PLAZA DR STE 101, LEESBURG, FL 34748-7328
(352) 728-6808
(352) 728-1743

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
28226
KY
2086S0129X
Vascular Surgery Physician
Primary
67029
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000226988
ANTHEM BCBS
KY
01
1165414
PASSPORT
KY
05
64050602
KY
01
770003165
RAILROAD MEDICARE
KY
Enumeration date
07/14/2005
Last updated
01/14/2019
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