Provider Demographics
NPI:1063711802
Name:VENDRYES, ILANA (MD)
Entity type:Individual
Prefix:DR
First Name:ILANA
Middle Name:
Last Name:VENDRYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ILANA
Other - Middle Name:
Other - Last Name:TORCHINOVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:901 45TH ST
Mailing Address - Street 2:
Mailing Address - City:MANGONIA PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2495
Mailing Address - Country:US
Mailing Address - Phone:800-437-2636
Mailing Address - Fax:954-618-4116
Practice Address - Street 1:1005 JOE DIMAGGIO DR
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5402
Practice Address - Country:US
Practice Address - Phone:954-265-5324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME129017207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicaid