Organization
FLORIDA HEART & VASCULAR MULTI SPECIALTY GROUP PA
Active
Organization
FLORIDA HEART & VASCULAR MULTI SPECIALTY GROUP PA
Active
Other names
Florida Heart & Vascular Center
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE FAUNDA (PHYSICIAN CREDENTIALING)
(352) 728-6808
Entity
Organization
Contact information
Practice address
511 MEDICAL PLAZA DR, SUITE 101, LEESBURG, FL 34748-7326
(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
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RN0300X
Nephrology Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21798
BCBS FLORIDA
FL
05
—
255260400
—
FL
01
—
695956
TUFTS
—
01
—
773114
MAILHANDLERS
—
01
—
7914953
MAMSI
—
01
—
CN9333
GBA RR PALMETTO
—
Enumeration date
08/31/2005
Last updated
09/13/2013
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up