Provider Demographics
NPI:1073188033
Name:SEENICHAMY, VENKATESAN (CPH; RPH)
Entity Type:Individual
Prefix:
First Name:VENKATESAN
Middle Name:
Last Name:SEENICHAMY
Suffix:
Gender:M
Credentials:CPH; RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 SERRANO CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-4952
Mailing Address - Country:US
Mailing Address - Phone:239-888-1149
Mailing Address - Fax:
Practice Address - Street 1:1407 SERRANO CIR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-4952
Practice Address - Country:US
Practice Address - Phone:239-888-1149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-22
Last Update Date:2021-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist