Provider Demographics
NPI:1356451306
Name:VENZARA, FRANK X (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:X
Last Name:VENZARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 N SYKES CREEK PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-3491
Mailing Address - Country:US
Mailing Address - Phone:321-452-3882
Mailing Address - Fax:321-454-7736
Practice Address - Street 1:280 N SYKES CREEK PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-3491
Practice Address - Country:US
Practice Address - Phone:321-452-3882
Practice Address - Fax:321-454-7736
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME33725207NS0135X, 207WX0200X, 2082S0099X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD51291Medicare UPIN
FL05445Medicare ID - Type Unspecified