# LEESBURG CARDIOVASCULAR ASSOCIATES LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FLORIDA HEART AND VASCULAR SURGEONS, PA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1952346017
- **Legal business name:** FLORIDA HEART AND VASCULAR SURGEONS, PA
- **Authorized official:** TREVA D WIDDIS (ADMINISTRATOR)
- **Authorized official phone:** (352) 787-9838

## Contact information

- **Practice address:** 700 DOCTORS CT, LEESBURG, FL 34748-7314
- **Practice address phone:** (352) 787-9838
- **Practice address fax:** (352) 787-8705
- **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:** 06/29/2020