Provider Demographics
NPI:1992003347
Name:ENTREVEST LLC
Entity Type:Organization
Organization Name:ENTREVEST LLC
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SVEJDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-649-8191
Mailing Address - Street 1:910 N PEBBLE BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-5302
Mailing Address - Country:US
Mailing Address - Phone:813-649-8191
Mailing Address - Fax:813-298-0396
Practice Address - Street 1:910 N PEBBLE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5302
Practice Address - Country:US
Practice Address - Phone:813-649-8191
Practice Address - Fax:813-298-0396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992773251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health