# VISTA CARDIOVASCULAR INNOVATIONS, LLC

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

## Provider details

- **NPI number:** 1629788153
- **Authorized official:** ENRIQUE RIVERA MD (OWNER)
- **Authorized official phone:** (941) 545-8954

## Contact information

- **Practice address:** 3904 CORTEZ RD W STE 300, BRADENTON, FL 34210-3204
- **Practice address phone:** (941) 545-8954
- **Mailing address:** 3904 CORTEZ RD W STE 300, BRADENTON, FL 34210-3204

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/23/2022
- **Last updated:** 11/23/2022