Provider Demographics
NPI:1003922683
Name:VENOKUR, STEPHEN J (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:VENOKUR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 NW 52ND CT
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067
Mailing Address - Country:US
Mailing Address - Phone:305-757-1759
Mailing Address - Fax:305-762-1600
Practice Address - Street 1:7901 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138
Practice Address - Country:US
Practice Address - Phone:305-757-1759
Practice Address - Fax:305-762-1600
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1341152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19312Medicare PIN