Provider Demographics
NPI:1992851497
Name:CORNERSTONE VENTURES, INC
Entity Type:Organization
Organization Name:CORNERSTONE VENTURES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADFORD
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:RAMPT
Authorized Official - Suffix:
Authorized Official - Credentials:ATS
Authorized Official - Phone:813-310-5032
Mailing Address - Street 1:8870 N HIMES AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1627
Mailing Address - Country:US
Mailing Address - Phone:813-908-5032
Mailing Address - Fax:813-908-7013
Practice Address - Street 1:5008 W LINEBAUGH AVE
Practice Address - Street 2:SUITE 22
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-5095
Practice Address - Country:US
Practice Address - Phone:813-908-5032
Practice Address - Fax:813-908-7013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312041332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR8897OtherBCBS FLORIDA
FLR8897OtherBCBS FLORIDA