Healthcare Provider Details

I. General information

NPI: 1881063543
Provider Name (Legal Business Name): HEALTHVENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 12/03/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 MAITLAND AVENUE SUITE #1000
ALTAMONTE SPRINGS FL
32701
US

IV. Provider business mailing address

PO BOX 150038
ALTAMONTE SPRINGS FL
32715-0038
US

V. Phone/Fax

Practice location:
  • Phone: 407-331-6236
  • Fax: 386-218-6861
Mailing address:
  • Phone: 407-782-3702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberPA9108843
License Number StateFL

VIII. Authorized Official

Name: DR. STEPHEN PHILIP NIMBARGI
Title or Position: OWNER
Credential: MD
Phone: 407-782-3702