Advanced Vascular Resources of Jacksonville, LLC

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

Legal business name

ADVANCED VASCULAR RESOURCES OF JACKSONVILLE, LLC

Practice address

4253 Salisbury Rd
Jacksonville, FL 32216-6121

Phone

(904) 416-1540

Fax

(904) 425-2137

NPI assigned

Jun 30, 2014

Organization subpart

No

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

Authorized official

Name

Barbara Odare

Title

Chief Executive Officer

Phone

(301) 434-0050

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• AVR of Jacksonville Other name

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409788800000",
    "number": "1114332962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 ELTON RD",
            "address_2": "SUITE 201",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209031752",
            "telephone_number": "904-416-1540",
            "fax_number": "904-425-2137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4253 SALISBURY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166121",
            "telephone_number": "904-416-1540",
            "fax_number": "904-425-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED VASCULAR RESOURCES OF JACKSONVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-09-04",
        "status": "A",
        "authorized_official_last_name": "ODARE",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "301-434-0050"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1205279122",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AVR of Jacksonville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Interventional Cardiology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Interventional Cardiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.