Basic Information
| Provider Information | |||||||||
| NPI: | 1568871986 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | VENAD | ||||||||
| FirstName: | GEORGY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4804 5TH ST | ||||||||
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| City: | ZEPHYRHILLS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335425733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7272262217 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7050 GALL BLVD | ||||||||
| Address2: | |||||||||
| City: | ZEPHYRHILLS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335411347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8137880411 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2014 | ||||||||
| LastUpdateDate: | 08/11/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WM0705X | RN9251181 | FL | Y | Nursing Service Providers | Registered Nurse | Medical-Surgical |
No ID Information.