Healthcare Provider Details

I. General information

NPI: 1497602619
Provider Name (Legal Business Name): WEST PASCO FREE SENIOR HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6640 VAN BUREN ST
NEW PORT RICHEY FL
34653-2649
US

IV. Provider business mailing address

6640 VAN BUREN ST
NEW PORT RICHEY FL
34653-2649
US

V. Phone/Fax

Practice location:
  • Phone: 727-844-3077
  • Fax: 727-844-3077
Mailing address:
  • Phone: 727-844-3077
  • Fax: 727-849-6124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. LORI VENTURA
Title or Position: PRESIDENT/OPERATIONS OFFICER
Credential:
Phone: 727-844-3077