Provider Demographics
NPI:1720075658
Name:VANGELDER, JAMES P (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:VANGELDER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3700 WASHINGTON ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8259
Mailing Address - Country:US
Mailing Address - Phone:954-962-0338
Mailing Address - Fax:954-962-2357
Practice Address - Street 1:3700 WASHINGTON ST
Practice Address - Street 2:SUITE 500
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8259
Practice Address - Country:US
Practice Address - Phone:954-962-0338
Practice Address - Fax:954-962-2357
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2009-12-11
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Provider Licenses
StateLicense IDTaxonomies
FLME22201207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD60367Medicare UPIN