Venezia,llc

NPI 1730529488 - Family Medicine - 207QA0505X

NPI Details
NPI 1730529488
Enumeration Date 06/26/2013
Last Updated 07/05/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name NICKOLAS NICKOLAS
Position FAMILY MEDICINE
Phone (863) 858-4402
Fax
Practice Location
1350 SLEEPY HILL RD
LAKELAND FL, 33810-3800, US
Phone (863) 858-4402
Fax
Business Location
1625 VILLAGE CENTER DR
APT 203
LAKELAND FL, 33803-2868, US
Phone
Fax
Toxanomy
Taxonomy Code 207QA0505X
License State Florida
License Number ME103560
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According to our database, Venezia,llc NPI is 1730529488, taxonomy code is 207QA0505X and license number is ME103560, license state is located at Florida. Venezia,llc physically located at 1350 Sleepy Hill Rd, Lakeland FL, 33810-3800. NPI Number 1033115704 has the healthcare provider type.

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1730529488 NPI number is provided on an as is basis without warranty of any kind. 1730529488 is maintained by the National Plan & Provider Enumeration System. The contents of Venezia,llc are for informational purposes only.