Provider Demographics
NPI:1073147260
Name:VENECIA MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:VENECIA MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL PINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-326-2667
Mailing Address - Street 1:6300 CORPORATE CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-3513
Mailing Address - Country:US
Mailing Address - Phone:772-237-0712
Mailing Address - Fax:239-471-0454
Practice Address - Street 1:5890 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-2656
Practice Address - Country:US
Practice Address - Phone:239-202-8998
Practice Address - Fax:239-471-0454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)