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General NPI Number Information
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NPI Number | 1801100326
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Entity Type | Individual
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Provider Name | DIANE VENTURA MS
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Gender | Female
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 07/27/2010
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Provider Practice Location Address
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Address Line | 4386 LAKE UNDERHILL RD SUITE 100
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City | ORLANDO
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State | FL
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Zip | 32803-7031
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Country | US
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Telephone | 407-760-0065
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Fax |
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Provider Business Mailing Address
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Address Line | 2056 ALOMA AVE SUITE 100
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City | WINTER PARK
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State | FL
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Zip | 32792-3340
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Country | US
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Telephone | 407-629-0413
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Fax | 407-629-2603
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | IMH 7517
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License Number State | FL
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