Provider Demographics
NPI:1467654053
Name:HEALTH VENTURES LLC
Entity Type:Organization
Organization Name:HEALTH VENTURES LLC
Other - Org Name:KIDZ AND FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:NIMBARGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-782-3702
Mailing Address - Street 1:PO BOX 150038
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32715-0038
Mailing Address - Country:US
Mailing Address - Phone:407-331-6236
Mailing Address - Fax:407-331-6953
Practice Address - Street 1:745 ORIENTA AVENUE
Practice Address - Street 2:STE #1191
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701
Practice Address - Country:US
Practice Address - Phone:407-331-6236
Practice Address - Fax:407-331-6953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85807207Q00000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1852839OtherUNITED HEALTH CARE
FL5324701OtherAETNA
FL113345OtherAMERIGROUP
FL26574200Medicaid
FL62948OtherBCBS
FL8665410OtherCIGNA
FL1852839OtherUNITED HEALTH CARE
G54861Medicare UPIN