Provider Demographics
NPI:1619642543
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:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL PINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-202-8998
Mailing Address - Street 1:5890 W 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2656
Mailing Address - Country:US
Mailing Address - Phone:239-202-8998
Mailing Address - Fax:239-270-5178
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:239-270-5178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty