Healthcare Provider Details

I. General information

NPI: 1487017554
Provider Name (Legal Business Name): TROY VENNING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 NW 14TH ST ROOM 1213 - UNIVERSITY OF MIAMI/EARLY STEPS PROGRAM
MIAMI FL
33136-2107
US

IV. Provider business mailing address

1120 NW 14TH ST ROOM 1213 - UNIVERSITY OF MIAMI/EARLY STEPS PROGRAM
MIAMI FL
33136-2107
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6600
  • Fax: 305-243-3501
Mailing address:
  • Phone: 305-243-6600
  • Fax: 305-243-3501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: