Cardiovascular Center of America

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

CARDIOVASCULAR CENTER OF AMERICA

Practice address

404 NW Hall of Fame Dr
Lake City, FL 32055-4833

Phone

(856) 335-5025

Fax

(856) 213-9269

NPI assigned

Apr 8, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

James O'Dare III

Title

Principal

Phone

(856) 335-5025

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554681600000",
    "number": "1063975175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N ROUTE 73 STE A6",
            "city": "WEST BERLIN",
            "state": "NJ",
            "postal_code": "080912440",
            "telephone_number": "856-335-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 NW HALL OF FAME DR",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554833",
            "telephone_number": "856-335-5025",
            "fax_number": "856-213-9269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR CENTER OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A",
        "authorized_official_last_name": "O'DARE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "856-335-5025",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Candler, MHS, ITDS
• Fenicia Canty, LPN
• Cantys Comfort Care
• Carc - Advocates for Citizens With Disabilities, Inc.
• Cardiology Associates of Gainesville
• Carmen E. Cardona, RPH
• Noranda Leigh Carey, LMT
• Caring Hearts Inc
• Maelyn Lee Carlucci
• Kayla Carman

• Vascular Surgery Physician in Lake City, FL
• Providers in Lake City, FL by specialty
• Vascular Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.