Provider Demographics
NPI:1972214146
Name:SENIOR VIRTUAL HEALTH LLC
Entity type:Organization
Organization Name:SENIOR VIRTUAL HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLECHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-531-9911
Mailing Address - Street 1:3201 TAMIAMI TRL N STE 106
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4135
Mailing Address - Country:US
Mailing Address - Phone:239-241-7683
Mailing Address - Fax:
Practice Address - Street 1:3201 TAMIAMI TRL N STE 106
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4135
Practice Address - Country:US
Practice Address - Phone:239-241-7683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization