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Individual

DR. EMANUEL J VLASTOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
207 W GORE ST STE 300, ORLANDO, FL 32806-1014
(321) 841-8555
(321) 841-2425
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939

Taxonomy

Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
118792
MO
207VM0101X
Maternal & Fetal Medicine Physician
Primary
ME154906
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
167050
BLUE CROSS BLUE SHIELD
MO
05
205955602
MO
01
272121
GROUP HEALTHPLAN
MO
01
2908754
CIGNA
MO
01
483444
HEALTHLINK
MO
01
5887070
AETNA
MO
01
7400111
UNITED HEALTHCARE
MO
Enumeration date
06/24/2006
Last updated
06/16/2022
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