Provider Demographics
NPI:1194708669
Name:VENDRYES, ANDRE (MD)
Entity type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:
Last Name:VENDRYES
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 1:1265 36TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6574
Mailing Address - Country:US
Mailing Address - Phone:772-567-6340
Mailing Address - Fax:772-567-3564
Practice Address - Street 1:1265 36TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6574
Practice Address - Country:US
Practice Address - Phone:772-567-6340
Practice Address - Fax:772-567-3564
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0076203207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDD1359OtherMEDICARE RAILROAD
FL44558OtherBCBS
FL44558YMedicare PIN
FLDD1359OtherMEDICARE RAILROAD