1336553817 NPI number — SETENOV ENTERPRISE CORPORATION

Table of content: (NPI 1336553817)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336553817 NPI number — SETENOV ENTERPRISE CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SETENOV ENTERPRISE CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336553817
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9702 UNIVERSAL BLVD
Provider Second Line Business Mailing Address:
B-325
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32819-8721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
470-505-9158
Provider Business Mailing Address Fax Number:
866-480-9482

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9702 UNIVERSAL BLVD
Provider Second Line Business Practice Location Address:
B-325
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32819-8721
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
470-505-9158
Provider Business Practice Location Address Fax Number:
866-480-9482
Provider Enumeration Date:
06/12/2014

Additional Information

Authorized Official

Authorized Official Last Name:
VONETES
Authorized Official First Name:
ALFRED
Authorized Official Middle Name:
DEAN
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
407-505-9158

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PY 8996 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC2200X , with the licence number: PY 8996 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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