Organization
FLORIDA HEART & VASCULAR MULTI SPECIALTY GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUNE LEW (TREASURER/CFO)
(352) 728-6808
Entity
Organization
Contact information
Practice address
802 E DIXIE AVE, LEESBURG, FL 34748-6014
(352) 728-6808
(352) 728-1743
Mailing address
511 MEDICAL PLAZA DR, SUITE 101, LEESBURG, FL 34748-7326
(352) 728-6808
(352) 728-1743
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME108692
FL
207RN0300X
Nephrology Physician
ME 108692
FL
261QP2300X
Primary Care Clinic/Center
ME 108692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14JE3
BCBS
FL
Enumeration date
09/19/2012
Last updated
04/01/2013
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