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General NPI Number Information
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NPI Number | 1104640267
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Entity Type | Organization
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Legal Business Name | SHETKA VENTURES, LLC
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 6106 S APOPKA VINELAND RD
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City | ORLANDO
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State | FL
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Zip | 32819-4407
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Country | US
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Telephone | 952-212-8192
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Fax |
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Provider Business Mailing Address
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Address Line | 6288 INDIAN MEADOW ST
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City | ORLANDO
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State | FL
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Zip | 32819-4967
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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 | CEO
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Name | MR. ANDREW SHETKA
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Credential | PA-C
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Telephone | 952-212-8192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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