Organization Active NPI

Premier Heart and Vascular Center, PA

  • Cardiovascular Disease Physician
  • Zephyrhills, FL
National Provider Identifier
1417060229
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME78413 Issued in FL
Legal business name
PREMIER HEART AND VASCULAR CENTER, PA
Practice address
38035 Medical Center Avenue
Zephyrhills, FL 33539
Phone
(813) 788-1400
Fax
(813) 788-7691
NPI assigned
Aug 16, 2006
Last updated
Jun 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Authorized official

Name
Sunil Gupta, MDNPI 1508979311
Title
Partner
Phone
(813) 788-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X ME78413 FL
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X ME78413 FL Primary

Addresses

Primary practice location

38035 Medical Center Avenue
Zephyrhills, FL 33539

Mailing address

PO Box 2709
Zephyrhills, FL 33539-2709
Phone (813) 788-1400

Other practice location 1

3675 Innovation Dr
Lakeland, FL 33812-4106
Phone (813) 788-1400

Other practice location 2

2615 Windguard Cir # 110
Wesley Chapel, FL 33544-7353
Phone (813) 788-1400

Other practice location 3

1470 N Florida Ave
Lakeland, FL 33805-3637
Phone (813) 788-1400

Other practice location 4

6646 Gunn Hwy
Tampa, FL 33625-4055
Phone (813) 788-1400

Other practice location 5

2477 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9213
Phone (813) 788-1400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060323000201 FL Part B Supplier - Clinic/Group Practice 0648288225 Receives reassigned benefits from 19 practitioners
Practice locations: Lakeland, FL; Zephyrhills, FL; Wesley Chapel, FL; Tampa, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2009026Premier Heart and Vascular Center2477 Bruce B Downs Blvd, Wesley Chapel, FL 33544Certificate of waiverJun 23, 2028
10D2121591Premier Heart and Vascular Center6646 Gunn Hwy, Tampa, FL 33625Certificate of waiverNov 7, 2026
10D2121592Premier Heart and Vascular Center PA1470 N Florida Ave, Lakeland, FL 33805Certificate of waiverNov 7, 2026
10D2229187Premier Heart and Vascular Center3675 Innovation Drive, Lakeland, FL 33812Certificate of waiverJul 7, 2027
10D2334820Premier Heart and Vascular Center, PA2615 Windguard Circle Unit 101, Wesley Chapel, FL 33544Certificate of waiverDec 1, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

13933 17th St
#100
Dade City, FL 33525

1470 Lakeland HLS Blvd
Lakeland, FL 33805

1470 N Florida Ave
Lakeland, FL 33805
Phone (863) 858-6666

1470 N Florida Ave
Ste 110
Lakeland, FL 33805

3675 Innovation Dr
Lakeland, FL 33812

6646 Gunn Hwy
Tampa, FL 33625

2477 Bruce B Downs Blvd
Wesley Chapel, FL 33544

2615 Windguard Cir
#110
Wesley Chapel, FL 33544

26827 Foggy Creek Rd
Ste 103
Wesley Chapel, FL 33544
Phone (813) 971-2424

38029 Medical Center Ave
Zephyrhills, FL 33540
Phone (352) 782-0478

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1417060229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2709",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335392709",
            "telephone_number": "813-788-1400",
            "fax_number": "813-788-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38035 MEDICAL CENTER AVENUE",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "33539",
            "telephone_number": "813-788-1400",
            "fax_number": "813-788-7691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3675 Innovation Dr",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338124106",
            "country_code": "US",
            "telephone_number": "813-788-1400",
            "fax_number": "813-788-7691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2615 Windguard Cir # 110",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335447353",
            "country_code": "US",
            "telephone_number": "813-788-1400",
            "fax_number": "813-788-7691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1470 N Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338053637",
            "country_code": "US",
            "telephone_number": "813-788-1400",
            "fax_number": "813-788-7691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6646 Gunn Hwy",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336254055",
            "country_code": "US",
            "telephone_number": "813-788-1400",
            "fax_number": "813-788-7691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2477 Bruce B Downs Blvd",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335449213",
            "country_code": "US",
            "telephone_number": "813-788-1400",
            "fax_number": "813-788-7691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER HEART AND VASCULAR CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "SUNIL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "813-788-1400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME78413",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME78413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.