| |
401 Commercial Ct, Ste E, Venice, FL 34292-1652 | |
(941) 492-6880 | |
(941) 492-6881 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor - Sports Physician |
Location | 401 Commercial Ct, Venice, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1568550853 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111NS0005X | Chiropractor - Sports Physician | CH6599 (Florida) | Primary |
Provider Name | Joanne J Fava |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1316035603 PECOS PAC ID: 2668500596 Enrollment ID: I20100513000267 |
Mailing Address | Practice Location Address |
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401 Commercial Ct, Ste E, Venice, FL 34292-1652 Ph: (941) 492-6880 | 401 Commercial Ct, Ste E, Venice, FL 34292-1652 Ph: (941) 492-6880 |
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