=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558295543
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VENANET PALM BEACH, P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2026
-----------------------------------------------------
Last Update Date | 06/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1167 BUSHEL CREEK XING
-----------------------------------------------------
City | LOXAHATCHEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33470-2131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-844-3577
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1167 BUSHEL CREEK XING
-----------------------------------------------------
City | LOXAHATCHEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33470-2131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-844-3577
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KSENIA ORLOVA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 352-844-3577
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0129X
-----------------------------------------------------
Taxonomy Name | Vascular Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------