Provider Demographics
NPI:1912123506
Name:CSV MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:CSV MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILFREDO
Authorized Official - Middle Name:MARCELINO
Authorized Official - Last Name:VENTURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-643-5120
Mailing Address - Street 1:711 NW 23RD AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3298
Mailing Address - Country:US
Mailing Address - Phone:305-643-5120
Mailing Address - Fax:305-643-5120
Practice Address - Street 1:711 NW 23RD AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3298
Practice Address - Country:US
Practice Address - Phone:305-643-5120
Practice Address - Fax:305-643-5120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME22003OtherSTATE LICENSE
D27644Medicare UPIN
FL99311AMedicare ID - Type UnspecifiedGROUP NUMBER