NPIMap

Organization Active NPI

Florida Heart & Vascular Multi Specialty Group, PA

  • Cardiovascular Disease Physician
  • The Villages, FL
National Provider Identifier
1295902377
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
FLORIDA HEART & VASCULAR MULTI SPECIALTY GROUP, PA
Practice address
1950 Laurel Manor Dr
Suite 142
The Villages, FL 32162-5603
Phone
(352) 326-7850
Fax
(352) 259-1605
NPI assigned
May 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Authorized official

Name
Jackie Faunda
Title
Physician Credentialing
Phone
(352) 728-6808

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X

Addresses

Primary practice location

1950 Laurel Manor Dr
Suite 142
The Villages, FL 32162-5603

Mailing address

511 Medical Plaza Dr
Suite 101
Leesburg, FL 34748-7326
Phone (352) 728-6808

Other identifiers 5

IdentifierTypeStateIssuer
695956OtherTUFTS
7194953OtherMAMSI
CN9333OtherRR PALMETTO GBA
773114OtherMAILHANDLERS
21798OtherFLBCBS OF FLORIDA

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.

Locations

1950 Laurel Manor Dr
Ste 142
The Villages, FL 32162
Phone (352) 326-7850

Practitioners & affiliated clinicians

Practitioners 4

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": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1295902377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 MEDICAL PLAZA DR",
            "address_2": "SUITE 101",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487326",
            "telephone_number": "352-728-6808",
            "fax_number": "352-728-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 LAUREL MANOR DR",
            "address_2": "SUITE 142",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625603",
            "telephone_number": "352-326-7850",
            "fax_number": "352-259-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA HEART & VASCULAR MULTI SPECIALTY GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "FAUNDA",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "PHYSICIAN CREDENTIALING",
        "authorized_official_telephone_number": "352-728-6808"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "695956",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "7194953",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PALMETTO GBA",
            "identifier": "CN9333",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAILHANDLERS",
            "identifier": "773114",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "21798",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.