Provider Demographics
NPI:1578893400
Name:VANETTEN, ROBERT
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:VANETTEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4981 SE STERLING CIR
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-6519
Mailing Address - Country:US
Mailing Address - Phone:772-781-6153
Mailing Address - Fax:888-781-9151
Practice Address - Street 1:4981 SE STERLING CIR
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-6519
Practice Address - Country:US
Practice Address - Phone:772-781-6153
Practice Address - Fax:888-781-9151
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472B0301XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherBiomedical Engineering