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:
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Health care specialties

SpecialtyCodeLicense #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 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487887295 NPPES
Florida MEDICAID 278018600
Florida Other 88976

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