Provider Demographics
NPI:1104133917
Name:LAMBERTO, VICTOR S (MD)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:S
Last Name:LAMBERTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 N OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5364
Mailing Address - Country:US
Mailing Address - Phone:646-505-9964
Mailing Address - Fax:
Practice Address - Street 1:4301 N OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5364
Practice Address - Country:US
Practice Address - Phone:646-505-9964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098719208000000X
FLME111301208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004326200Medicaid