Individual ProviderVenette St VryNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address52 W Underwood St, Orlando, FL 32806-1110(407) 489-2939PECOS EnrollmentBased on the most recent information from CMS, provider Venette St Vry does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1336770791Provider TypeIndividualFull NameSt Vry, VenetteGenderFemaleSole ProprietorNoEnumeration Date2/3/2020Last Updated2/3/2020Contact InformationPractice LocationPractice Address52 W Underwood St, Orlando, FL 32806-1110Phone(407) 489-2939FaxUnlisted FaxMailing LocationMailing Address8411 Rose Groves Rd, Orlando, FL 32818-5690Phone(407) 489-2939FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense11005668Florida