Healthcare Provider Details

I. General information

NPI: 1851753909
Provider Name (Legal Business Name): VIJAY NARASIMHAN SRINIVASAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: VEN HEALTH LLC

II. Dates (important events)

Enumeration Date: 03/27/2016
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 JOHN F KENNEDY DR
ATLANTIS FL
33462-1119
US

IV. Provider business mailing address

101 JOHN F KENNEDY DR
ATLANTIS FL
33462-1119
US

V. Phone/Fax

Practice location:
  • Phone: 585-469-6890
  • Fax:
Mailing address:
  • Phone: 585-469-6890
  • Fax: 800-792-9021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME139668
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME139668
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: