Cardiovascular and Surgical First Assistants of Central Florida, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

CARDIOVASCULAR AND SURGICAL FIRST ASSISTANTS OF CENTRAL FLORIDA, PA

Practice address

4584 Old Carriage TRL
Oviedo, FL 32765-8473

Phone

(407) 491-0114

Fax

(407) 679-4343

NPI assigned

Jun 11, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Michael Rucker, PA-C

Title

President

Phone

(407) 701-4253

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1245467729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4584 OLD CARRIAGE TRL",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658473",
            "telephone_number": "407-491-0114",
            "fax_number": "407-679-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4584 OLD CARRIAGE TRL",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658473",
            "telephone_number": "407-491-0114",
            "fax_number": "407-679-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR AND SURGICAL FIRST ASSISTANTS OF CENTRAL FLORIDA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-11",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-701-4253",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nayer Canton Vafabakhsh, M.D
• Dotie Linia Cantrell, LMT
• Tiffany Cappelen, LCSW
• Staci Capps, COTA
• Carcamo Pediatrics, Inc
• Carehere LLC (Carehere-Oveido)
• Olivia Ann Carlton
• Melissa Carman, BS, ITDS
• Mirella Caro-Cortes
• Mary Lu Carpenter, R.D.

• Surgical Physician Assistant in Oviedo, FL
• Providers in Oviedo, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.