Provider Demographics
NPI:1407843923
Name:DRAPER, VICTORIA SIDDENS (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:SIDDENS
Last Name:DRAPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 ADRIATIC DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4105
Mailing Address - Country:US
Mailing Address - Phone:305-978-1718
Mailing Address - Fax:
Practice Address - Street 1:502 W HIGHLAND BLVD
Practice Address - Street 2:PHOENIX EMERGENCY SERVICES OF INVERNESS, LLC
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4720
Practice Address - Country:US
Practice Address - Phone:352-726-1551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80420207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G06662Medicare UPIN