Individual
VINCENT A DEGENNARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1201 NW 16TH ST, MIAMI, FL 33125-1624
(305) 575-3244
(305) 575-3255
Mailing address
1201 NW 16TH ST, MIAMI, FL 33125-1624
(305) 575-3244
(305) 575-3255
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME50676
FL
208C00000X
Colon & Rectal Surgery Physician
ME50676
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002517
NEIGHBORHOOD HEALTH
FL
01
—
020012679
RAILROAD RETIREMENT
—
01
—
03892
BLUE CROSS BLUE SHIELD
FL
01
—
225451
AVMED
FL
01
—
4075362
AETNA
—
01
—
D19041
VISTA
FL
Enumeration date
10/13/2005
Last updated
07/30/2009
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