Organization Active NPI

Heart of Florida Cardiovascular Consultants PA

  • Specialist
  • Weeki Wachee, FL
National Provider Identifier
1174748115
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME59444 Issued in FL
Legal business name
HEART OF FLORIDA CARDIOVASCULAR CONSULTANTS PA
Practice address
10145 Cortez Blvd
Weeki Wachee, FL 34613-6385
Phone
(352) 597-4631
Fax
(352) 597-0076
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Authorized official

Name
Dr. Andre M Brooks, M.D.
Title
Owner
Phone
(352) 597-4631

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME59444 FL Primary

Addresses

Primary practice location

10145 Cortez Blvd
Weeki Wachee, FL 34613-6385

Mailing address

10091 Cortez Blvd
Weeki Wachee, FL 34613-6378
Phone (352) 597-4631

Other identifiers 1

IdentifierTypeStateIssuer
054647000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120206000198 FL Part B Supplier - Clinic/Group Practice 4880851708 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brooksville, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

5975 S Suncoast Blvd
Homosassa, FL 34446
Phone (352) 628-3212

10145 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 597-4631

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1174748115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10091 CORTEZ BLVD",
            "city": "WEEKI WACHEE",
            "state": "FL",
            "postal_code": "346136378",
            "telephone_number": "352-597-4631",
            "fax_number": "352-597-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10145 CORTEZ BLVD",
            "city": "WEEKI WACHEE",
            "state": "FL",
            "postal_code": "346136385",
            "telephone_number": "352-597-4631",
            "fax_number": "352-597-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART OF FLORIDA CARDIOVASCULAR CONSULTANTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-597-4631",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME59444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054647000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weeki Wachee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.