Provider Demographics
NPI:1174842884
Name:VENTURA, CARLOS JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:JOSE
Last Name:VENTURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 PRESTIGE PL STE 550
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6115
Mailing Address - Country:US
Mailing Address - Phone:937-762-1310
Mailing Address - Fax:937-522-8068
Practice Address - Street 1:1745 E STROOP RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-5039
Practice Address - Country:US
Practice Address - Phone:937-281-6342
Practice Address - Fax:937-281-6342
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ47262207R00000X, 207RG0300X
OH35.145436207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine