Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Clay Vandenberg, OTA

Individual provider Orthopaedic Surgery Physician · NPI 1679065411

Clay Vandenberg, OTA is an Orthopaedic Surgery Physician in Saint Augustine, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2018
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Practice location Address checks out

1 Orthopaedic Pl
Saint Augustine, FL 32086-4202
Phone: (904) 825-0540
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Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence 1770020919 (FL)

Record details

NPI number1679065411
Entity typeIndividual (Type 1)
GenderMale
Credentials OTA
Sole proprietorYes
NPI enumeratedJune 6, 2018
Last updated in NPPESJune 6, 2018

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