Organization
STUART CARDIOVASCULAR ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVA D. WIDDIS (ADMINISTRATOR)
(352) 787-9838
Entity
Organization
Contact information
Practice address
524 SE OSCEOLA ST, SUITE 100, STUART, FL 34994-2322
(772) 419-2379
(772) 419-2377
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00721
BCBS OF FLORIDA
FL
05
—
275299900
—
FL
Enumeration date
06/18/2006
Last updated
06/05/2020
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