Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME108728 | FL |
NPI | 1053522144 |
---|---|
Provider Name | Dr. Alexander Van Der Ven |
First Address | Atlanta, GA 30384-0905 |
Second Address | Miami, FL 33176-2150 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 03/02/2022 |