# VENICE CARDIOVASCULAR ASSOCIATES PL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316982473
- **Authorized official:** TREVA D. WIDDIS (ADMINISTRATOR)
- **Authorized official phone:** (352) 787-9838

## Contact information

- **Practice address:** 706 THE RIALTO, VENICE, FL 34285-3524
- **Practice address phone:** (941) 484-8004
- **Practice address fax:** (941) 484-8869
- **Mailing address:** 700 DOCTORS CT, LEESBURG, FL 34748-7314
- **Mailing address phone:** (352) 787-9838
- **Mailing address fax:** (352) 787-8705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/20/2006
- **Last updated:** 06/05/2020