MEDICARE: FRANK X VENZARA MDPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	173000000X	Legal Medicine	ME33725	FL

General Provider Information

NPI Number	:	1013182880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANK X VENZARA MDPA

Provider Business Mailing Address
First Line	:	280 N SYKES CREEK PKWY
Second Line	:	SUITE A
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-3491
Country	:	US
Telephone Number	:	321-452-3882
Fax Number	:	321-454-7736

Provider Business Practice Location Address
First Line	:	280 N SYKES CREEK PKWY
Second Line	:	SUITE A
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-3491
Country	:	US
Telephone Number	:	321-452-3882
Fax Number	:	321-454-7736

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	FRANK X VENZARA
Credential	:	MD
Telephone Number	:	321-452-3882

Provider Enumeration Date	:	04/23/2008
Last Update Date	:	04/23/2008

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