CARDIOVASCULAR ASSOCIATES OF LAKE COUNTY, PA (NPI# 1679508063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679508063 |
| Entity Type | Organization |
| Organization Name | CARDIOVASCULAR ASSOCIATES OF LAKE COUNTY, PA |
| Practice Address |
1879 Nightingale Lane Suite C-1 Tavares FL 32778 |
| Practice Telephone | 3527421171 |
| Practice Fax Number | 3527427241 |
| Mailing Telephone | 3527421171 |
| Mailing Fax Number | 3527427241 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2013-04-29 |
| Authorized Official Name | DR. SAMUEL J GOSS (PRESIDENT) |
| Authorized Official Telephone | 3527421171 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 374579100 | 05 |
| Street Address |
1879 NIGHTINGALE LANE SUITE C-1 |
| City | TAVARES |
| State | FL |
| Zip Code | 32778 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558398784 | Miguel Bryce | Internal Medicine | 1879 Nightingale Lane, Suite C1, Tavares, FL 32778 | 2006-06-26 |
| 1972820546 | Us Radiology Center, LLC | Radiologic Technologist | 1879 Nightingale Lane, Suite A1, Tavares, FL 32708 | 2010-04-22 |
| 1437184090 | Sunshine State Surgical Specialists Pa | Surgery | 1879 Nightingale Lane, Suite B3, Tavares, FL 32778 | 2006-07-12 |
| 1063443653 | Samuel J Goss | Internal Medicine | 1879 Nightingale Lane, Suite C1, Tavares, FL 32778 | 2006-07-05 |
| 1649201377 | Borys A Mascarenhas Md Pa | Surgery | 1879 Nightingale Lane, Suite B4, Tavares, FL 32778 | 2006-07-05 |
| 1689603375 | Moises Fraifeld | Internal Medicine | 1879 Nightingale Lane, Suite C1, Tavares, FL 32778 | 2006-07-03 |
| 1003845793 | Christine Desantis | Nurse Practitioner | 1879 Nightingale Lane, Suite C-1, Tavares, FL 32778 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487173753 | Erica Denise Irvin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4681 Marsh Harbor Dr, Tavares, FL 32778 | 2017-09-18 |
| 1922522499 | J&t Divine Care | Home Health | 1554 Auburn Hills Ct, Tavares, FL 32778 | 2017-07-27 |
| 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 |
| 1396295713 | Sumiko Burley- Collins | Community Health Worker | 1572 Auburn Hills Court, Tavares, FL 32778 | 2016-10-10 |
| 1295100980 | Sunshine Therapy Group, Pa | Speech-Language Pathologist | 2050 Classique Lane, Tavares, FL 32778 | 2015-12-06 |
| 1093188385 | Jana Michelle England | Counselor | 1300 Duncan, Tavares, FL 32778 | 2015-11-09 |
| 1467865980 | Reshma Balmick | Hearing Instrument Specialist | 500 West Burleigh Blvd., Tavares, FL 32778 | 2014-06-03 |
| 1861825739 | Shelagh Kathryn Wood-gouveia | Nurse Practitioner | 1390 East Burleigh Blvd., Tavares, FL 32778 | 2013-08-15 |
| Find all providers in zip 32778 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346876745 | H & D Cardiology, Pa | Internal Medicine | 1879 Nightingale Ln Ste B2, Tavares, FL 32778-4363 | 2020-03-17 |
| 1609162064 | Sameh Nazeeh Adly Mohareb | Internal Medicine | 1825 Salk Ave, Tavares, FL 32778-4311 | 2011-06-23 |
| 1093806499 | Thomas F Parente | Internal Medicine | 2101 Nightingale Ln, Tavares, FL 32778-4365 | 2006-09-28 |
| 1669403259 | Alejandro A Caballero | Internal Medicine | 1879 Nightingale Ln # Ln2, Tavares, FL 32778-4363 | 2006-07-05 |
| 1558398784 | Miguel Bryce | Internal Medicine | 1879 Nightingale Lane, Suite C1, Tavares, FL 32778 | 2006-06-26 |
| 1396747424 | Sammy Arnold Gammenthaler | Internal Medicine | 1815 Salk Ave, Tavares, FL 32778-4311 | 2005-06-01 |
| 1225332075 | Central Florida Cardiology & Vascular Center LLC | Internal Medicine | 1815 Salk Ave, Tavares, FL 32778-4311 | 2011-01-07 |
| 1508957846 | Heart Care & Vascular Medicine P A | Internal Medicine | 2101 Nightingale Ln, Tavares, FL 32778-4365 | 2006-09-28 |
| 1063443653 | Samuel J Goss | Internal Medicine | 1879 Nightingale Lane, Suite C1, Tavares, FL 32778 | 2006-07-05 |
| 1689603375 | Moises Fraifeld | Internal Medicine | 1879 Nightingale Lane, Suite C1, Tavares, FL 32778 | 2006-07-03 |
| Find all providers in TAVARES | ||||
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| 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.