Provider Demographics
NPI:1154535292
Name:VANVLEET, JOANNA L (DO)
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:L
Last Name:VANVLEET
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1555 NW SAINT LUCIE WEST BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-1758
Mailing Address - Country:US
Mailing Address - Phone:772-878-7216
Mailing Address - Fax:772-878-7218
Practice Address - Street 1:1555 NW ST. LUCIE WEST BLVD.
Practice Address - Street 2:SUITE 201
Practice Address - City:PORT ST. LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-1728
Practice Address - Country:US
Practice Address - Phone:772-878-7216
Practice Address - Fax:772-878-7218
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2011-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 103202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry