NPIMap

Organization Active NPI

Florida Heart & Vascular Multi Specialty Group, PA

Doing business as Fredric M. Davis,DO

  • Family Medicine Physician
  • Leesburg, FL
National Provider Identifier
1154453074
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FLORIDA HEART & VASCULAR MULTI SPECIALTY GROUP, PA
Doing business as
Fredric M. Davis,DO
Practice address
704 Doctors CT
Leesburg, FL 34748-7314
Phone
(352) 326-7850
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Regina Ingram
Title
Administrator
Phone
(352) 728-6808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

704 Doctors CT
Leesburg, FL 34748-7314

Mailing address

511 Medical Plaza Dr
Leesburg, FL 34748-7326
Phone (352) 728-6808

Other names 1

  • Fredric M. Davis,DO Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Florida Heart Vascular Group PA11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154453074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 MEDICAL PLAZA DR",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487326",
            "telephone_number": "352-728-6808",
            "fax_number": "352-728-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 DOCTORS CT",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487314",
            "telephone_number": "352-326-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA HEART & VASCULAR MULTI SPECIALTY GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "REGINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "352-728-6808"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fredric M. Davis,DO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.