Organization
BAHMAN VENUS,M.D, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE P KRIEGER M.D. (PRESIDENT)
(904) 399-6097
Entity
Organization
Contact information
Practice address
3625 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4207
(904) 399-6111
Mailing address
PO BOX 863007, ORLANDO, FL 32886-3007
(904) 396-5558
(904) 396-4279
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062000900
—
FL
Enumeration date
11/01/2006
Last updated
02/22/2011
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