KEITH VENNUM (NPI# 1952415119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952415119 |
| Entity Type | Individual |
| Full Name | KEITH VENNUM |
| Credential | MD |
| Practice Address |
5728 Major Blvd #506 Orlando FL 32819-7945 |
| Mailing Address |
150 E Robinson St Unit 2201 Orlando FL 32801-1695 |
| Practice Telephone | 4072058833 |
| Practice Fax Number | 3212476983 |
| Mailing Telephone | 8635298491 |
| Mailing Fax Number | 3212476983 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2016-06-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
MH 11014 | FL | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
MH 11014 | FL | Behavioral Health & Social Service Providers |
| N | 207LA0401X |
Anesthesiology Specialization: Addiction Medicine |
ME24611 | FL | Allopathic & Osteopathic Physicians |
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
ME24611 | FL | Allopathic & Osteopathic Physicians |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
ME24611 | FL | Allopathic & Osteopathic Physicians |
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
ME24611 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE | 68002A | 01 |
| FL | 003353900 | 05 |
| Street Address |
5728 MAJOR BLVD #506 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32819-7945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902801863 | Matthew Bryce Owen | Internal Medicine | 5728 Major Blvd, Suite 528, Orlando, FL 32819-7945 | 2005-06-16 |
| 1750839536 | Shelley Carmine Bowles, Lcsw, Pa | Social Worker | 5728 Major Blvd, #175, Orlando, FL 32819-7961 | 2016-09-21 |
| 1710432703 | Samantha Ann Ginsburg | Counselor | 5728 Major Blvd, Suite 506, Orlando, FL 32819-7945 | 2016-08-18 |
| 1952791824 | Hai Phan | Internal Medicine | 5728 Major Blvd, Suite 528, Orlando, FL 32819-7962 | 2015-01-30 |
| 1568801777 | Rushabh Vakharia | Hospitalist | 5728 Major Blvd, #528, Orlando, FL 32819-7945 | 2013-06-20 |
| 1528300365 | Arupa Yashswini Khusial | Family Medicine | 5728 Major Blvd, Suite 528, Orlando, FL 32819-7945 | 2013-03-19 |
| 1386981603 | Yulonda Leverett | Nurse Practitioner | 5728 Major Blvd, Suite 528, Orlando, FL 32819-7945 | 2013-01-07 |
| 1437465176 | Birget Ann Ukaegbu | Nurse Practitioner | 5728 Major Blvd, Suite 528, Orlando, FL 32819-7945 | 2010-08-19 |
| 1225278005 | Melissa Singh | Social Worker | 5728 Major Blvd, Suite 278, Orlando, FL 32819-7945 | 2009-03-06 |
| 1417157066 | Alex Seda | Internal Medicine | 5728 Major Blvd, Suite #528, Orlando, FL 32819-7945 | 2007-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093356842 | Crew Community Health, Inc | Internal Medicine | 8601 Commodity Circle, Orlando, FL 32819 | 2019-10-03 |
| 1437704756 | Byron Martin Randolph | Physical Therapist | 7932 Sand Lake Rd Ste 203, Orlando, FL 32819 | 2019-08-04 |
| 1225536303 | Alliance Dme LLC | Durable Medical Equipment & Medical Supplies | 7031 Grand National Dr Ste 106b, Orlando, FL 32819 | 2018-01-24 |
| 1417465584 | Marckenson Gerson Janvier | Nurse Practitioner | 9401 Turkey Lake Rd, Orlando, FL 32819 | 2018-01-11 |
| 1871003442 | Sabeen Hasni | Pharmacist | 2354 Commerce Park Drive Ste 100, Orlando, FL 32819 | 2017-10-09 |
| 1902343775 | Darleen Walker | Occupational Therapist | 7243 Della Dr., Orlando, FL 32819 | 2017-01-31 |
| 1215483565 | Krista Richardson | Physical Therapist | 9102 Universal Blvd., Orlando, FL 32819 | 2016-08-28 |
| 1841646536 | Kiara Serrano | Social Worker | 7509 Pinemount Dr, Orlando, FL 32819 | 2016-05-11 |
| 1659749752 | Angels for Kids On-call | Case Management | 7550 Future Drive Suite 105, Orlando, FL 32819 | 2015-09-04 |
| 1932589462 | Krista Jean Cain | Counselor | 7758 Wallace Rd Ste Vi, Orlando, FL 32819 | 2015-05-29 |
| Find all providers in zip 32819 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114575636 | Mosaico Mental Health Center Corp | Psychiatry & Neurology | 12315 Lake Underhill Rd Ste B, Orlando, FL 32828-4507 | 2019-08-28 |
| 1326602566 | Lake Nona Psychiatric Associates, LLC | Psychiatry & Neurology | 8511 Adalina Pl, Orlando, FL 32827-7277 | 2019-04-23 |
| 1063986461 | Sunshine Premier Wellness Center LLC | Psychiatry & Neurology | 4365 Hunters Park Ln # 50, Orlando, FL 32837-7614 | 2019-01-18 |
| 1578918462 | Sbm Medical Services, LLC. | Psychiatry & Neurology | 14225 Ludgate Hill Ln, Orlando, FL 32828-7921 | 2016-04-27 |
| 1487919932 | Luis Javier Olivera-rodriguez | Psychiatry & Neurology | 6001 Vineland Rd Ste 109, Orlando, FL 32819-7829 | 2012-07-11 |
| 1568627701 | Bay Hill Psychiatric Associates LLC | Psychiatry & Neurology | 2869 Wilshire Dr Ste 203, Orlando, FL 32835-3282 | 2008-07-28 |
| 1598932378 | The Gutman Pain/accident Center, Inc | Psychiatry & Neurology | 301 N Fern Creek Ave, Orlando, FL 32803-5400 | 2008-05-12 |
| 1750407680 | Samuel Sidney Mcclure | Psychiatry & Neurology | 504 N.wymore Rd., Orlando, FL 32789 | 2007-03-22 |
| 1801912894 | Aysha Meloukheia | Psychiatry & Neurology | 422 S Alafaya Trail Suite 17, Orlando, FL 32828 | 2007-03-21 |
| 1962542282 | Earl Paul Taitt Jr. | Psychiatry & Neurology | 4151 Hunters Park Lane, Suite 100, Orlando, FL 32837-7690 | 2007-02-07 |
| Find all providers in ORLANDO | ||||
Please comment or provide details below to improve the information on KEITH VENNUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.