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General NPI Number Information
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NPI Number | 1043041288
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Entity Type | Organization
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Legal Business Name | EKOS VENTURA, PLLC
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Dates
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Enumeration Date | 08/09/2024
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 2615 SIMPSON RD
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City | KISSIMMEE
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State | FL
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Zip | 34744-4675
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Country | US
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Telephone | 321-351-2294
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Fax |
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Provider Business Mailing Address
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Address Line | 8794 BOYNTON BEACH BLVD STE 218
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-4469
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPERATIONS
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Name | GIOVANNA DEJESUS
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Credential |
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Telephone | 561-899-7115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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