Provider Demographics
NPI:1942201355
Name:LINDENTHAL, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:LINDENTHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1555 INDIAN RIVER BLVD
Mailing Address - Street 2:SUITE B120
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5639
Mailing Address - Country:US
Mailing Address - Phone:772-778-9621
Mailing Address - Fax:772-778-3494
Practice Address - Street 1:1555 INDIAN RIVER BLVD
Practice Address - Street 2:SUITE B120
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5639
Practice Address - Country:US
Practice Address - Phone:772-778-9621
Practice Address - Fax:772-778-3494
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NHNH10428174400000X
FL96091207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30200027Medicaid
NHRE4964Medicare ID - Type Unspecified
NH30200027Medicaid