Central Florida Cardiovascular Imaging Center, LLC

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

Legal business name

CENTRAL FLORIDA CARDIOVASCULAR IMAGING CENTER, LLC

Practice address

1717 Mayo Dr
Tavares, FL 32778-4307

Phone

(352) 253-0003

Fax

(352) 253-0016

NPI assigned

Jun 11, 2018

Last updated

Mar 4, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melissa G McClure

Title

Credentialing Specialist

Phone

(281) 703-1258

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551657600000",
    "number": "1205329620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 MAYO DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784307",
            "telephone_number": "352-253-0003",
            "fax_number": "352-253-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 MAYO DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784307",
            "telephone_number": "352-253-0003",
            "fax_number": "352-253-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA CARDIOVASCULAR IMAGING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-11",
        "last_updated": "2019-03-04",
        "status": "A",
        "authorized_official_last_name": "MCCLURE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "281-703-1258"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Central Florida Premier Eye Associates (Lake Eye Associates)
• Central Florida Urology Specialists

• Interventional Cardiology Physician in Tavares, FL
• Providers in Tavares, 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 Mar 4, 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.