Healthcare Provider Details

I. General information

NPI: 1093407231
Provider Name (Legal Business Name): VENI TOUCH LABS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 E HENRY AVE
TAMPA FL
33604-7143
US

IV. Provider business mailing address

6902 WILLIAMS DR
TAMPA FL
33634-2951
US

V. Phone/Fax

Practice location:
  • Phone: 813-510-5105
  • Fax:
Mailing address:
  • Phone: 617-756-1116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAELLE DORICENT
Title or Position: OWNER
Credential: PHLEBOTOMIST
Phone: 617-756-1116