Organization
FLORIDA HEART AND VASCULAR SURGEONS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVA D. WIDDIS (ASSOCIATE EXECUTIVE DIRECTOR)
(352) 867-8311
Entity
Organization
Contact information
Practice address
1511 SW 1ST AVE, OCALA, FL 34471-6505
(352) 867-8311
(352) 622-5771
Mailing address
PO BOX 3130, OCALA, FL 34478-3130
(352) 867-8311
(352) 622-5771
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
378057100
—
FL
01
—
72180
BCBS OF FLORIDA
FL
Enumeration date
06/13/2006
Last updated
01/14/2016
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