Provider Demographics
NPI:1306849476
Name:VANEK, JAMES EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:VANEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N FLAGLER DR
Mailing Address - Street 2:STE 4500
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3404
Mailing Address - Country:US
Mailing Address - Phone:561-659-5154
Mailing Address - Fax:561-659-3820
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:STE 4500
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3404
Practice Address - Country:US
Practice Address - Phone:561-659-5154
Practice Address - Fax:561-659-3820
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0035984207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79532Medicare ID - Type Unspecified
FLD58831Medicare UPIN