Provider Demographics
NPI:1548329048
Name:VERNOF, HOWARD (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:VERNOF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HOWARD
Other - Middle Name:
Other - Last Name:VERNOF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5850 CAMINO DEL SOL APT 304
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-6542
Mailing Address - Country:US
Mailing Address - Phone:847-287-0030
Mailing Address - Fax:847-570-1248
Practice Address - Street 1:5850 CAMINO DEL SOL APT 304
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-6542
Practice Address - Country:US
Practice Address - Phone:847-287-0030
Practice Address - Fax:847-570-1248
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-047531207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC42213Medicare UPIN