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Organization
VENICE CARDIOVASCULAR ASSOCIATES PL
Active
Organization
VENICE CARDIOVASCULAR ASSOCIATES PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVA D. WIDDIS (ADMINISTRATOR)
(352) 787-9838
Entity
Organization
Contact information
Practice address
706 THE RIALTO, VENICE, FL 34285-3524
(941) 484-8004
(941) 484-8869
Mailing address
700 DOCTORS CT, LEESBURG, FL 34748-7314
(352) 787-9838
(352) 787-8705
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
06/20/2006
Last updated
06/05/2020
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