CENTRAL FLORIDA CARDIOVASCULAR IMAGING CENTER, LLC


Address: 1717 Mayo Dr, Tavares, FL 32778-4307
Phone: 3522530003

CENTRAL FLORIDA CARDIOVASCULAR IMAGING CENTER, LLC (NPI# 1205329620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205329620
Entity Type Organization
Organization Name CENTRAL FLORIDA CARDIOVASCULAR IMAGING CENTER, LLC
Practice Address 1717 Mayo Dr
Tavares
FL 32778-4307
Practice Telephone 3522530003
Practice Fax Number 3522530016
Mailing Telephone 3522530003
Mailing Fax Number 3522530016
Enumeration Date 2018-06-11
Last Update Date 2019-03-04
Authorized Official Name MELISSA G MCCLURE (CREDENTIALING SPECIALIST)
Authorized Official Telephone 2817031258
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RI0011X Internal Medicine
Specialization: Interventional Cardiology
Allopathic & Osteopathic Physicians

Office Location

Street Address 1717 MAYO DR
City TAVARES
State FL
Zip Code 32778-4307

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1841738721 Kelli Maragh Behavior Technician 12237 Tavares Ridge Circle, Tavares, FL 32778 2017-02-10
1831633692 Amanda Williams Sellers Nurse Practitioner 1858 Mayo Dr, Tavares, FL 32778 2016-12-13
1235680042 Natalie Roaine Ash-maheux Occupational Therapist 4501 Waterman Way, Tavares, FL 32778 2016-10-17
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1861825739 Shelagh Kathryn Wood-gouveia Nurse Practitioner 1390 East Burleigh Blvd., Tavares, FL 32778 2013-08-15
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Taxonomy Information

Taxonomy Code 207RI0011X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Interventional Cardiology

Taxonomy Definition

An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine)

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1821612821 Satish Sivasankaran Md Pa Internal Medicine 5340 Gulf Dr Ste 101, New Port Richey, FL 34652-3922 2020-06-04
1699317933 Abid A Shah Md LLC Internal Medicine 5741 Bee Ridge Rd Ste 420, Sarasota, FL 34233-5081 2019-10-08
1154802833 John-paul Pham Internal Medicine 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 2018-08-22
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Competitor

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City TAVARES
Zip Code 32778

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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