Peterson, Vincent Glenn
Peterson, Vincent Glenn is an individual health care provider with primary practice located at 695 N Clyde Morris Blvd , Daytona Beach FL 32114-2321. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Cardiology, Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Peterson, Vincent Glenn can be contacted via phone (386) 258-8722.Contact Information
Primary practice address
695 N Clyde Morris Blvd
Daytona Beach FL 32114-2321
Phone: (386) 258-8722
Fax: (386) 258-9443
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nuclear Cardiology | 207UN0901X | OS14032 | Florida |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | OS14032 | Florida |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | OS14032 | Florida |
Profile Details
| NPI number | 1487887295 |
|---|---|
| LBN Legal business name | Peterson, Vincent Glenn |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2009 |
| Last updated | Sep 19th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487887295 | NPPES |
| Florida | MEDICAID | 278018600 | |
| Florida | Other | 88976 |
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