Robert J. Van Der Leest MD, Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ROBERT J. VAN DER LEEST MD, INC.

Practice address

800 E Broward Blvd
Suite 507
Fort Lauderdale, FL 33301-2008

Phone

(954) 736-4331

Fax

(954) 763-4775

NPI assigned

Jan 15, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert Vanderleest, MD

Title

MD

Phone

(650) 324-9135

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389830400000",
    "number": "1215359872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CREEK DR",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940255317",
            "telephone_number": "650-324-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E BROWARD BLVD",
            "address_2": "SUITE 507",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012008",
            "telephone_number": "954-736-4331",
            "fax_number": "954-763-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J. VAN DER LEEST MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-16",
        "status": "A",
        "authorized_official_last_name": "VANDERLEEST",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "650-324-9135",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1639254394",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.