Organization Active NPI

Cardiovascular Care Centers PA

  • Specialist
  • Orlando, FL
National Provider Identifier
1295907343
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0065144 Issued in FL
Legal business name
CARDIOVASCULAR CARE CENTERS PA
Practice address
100 W Gore St
Suite 403
Orlando, FL 32806
Phone
(407) 872-8588
Fax
(407) 872-1875
NPI assigned
Mar 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Authorized official

Name
Dr. Caleb Mercado, M.D.
Title
Cardiologist
Phone
(407) 872-8588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X ME0065144 FL Primary

Addresses

Primary practice location

100 W Gore St
Suite 403
Orlando, FL 32806

Mailing address

100 W Gore St Ste 403
Orlando, FL 32806-1049
Phone (407) 872-8588

Other identifiers 2

IdentifierTypeStateIssuer
009792100MedicaidFL
K4843OtherFLPTAN

National Provider Directory

National Provider Directory

Locations

100 W Gore St
Ste 403
Orlando, FL 32806
Phone (407) 872-8588

100 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

NPI Registry JSON

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529366400000",
    "number": "1295907343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W GORE ST STE 403",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061049",
            "telephone_number": "407-872-8588",
            "fax_number": "407-872-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W GORE ST",
            "address_2": "SUITE 403",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32806",
            "telephone_number": "407-872-8588",
            "fax_number": "407-872-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR CARE CENTERS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2018-06-19",
        "status": "A",
        "authorized_official_last_name": "MERCADO",
        "authorized_official_first_name": "CALEB",
        "authorized_official_title_or_position": "CARDIOLOGIST",
        "authorized_official_telephone_number": "407-872-8588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0065144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009792100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "K4843",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.