NPIMap

Organization Active NPI

Florida Heart & Vascular Multi Specialty Group, PA

Doing business as Leesburg Family Medicine

  • Family Medicine Physician
  • Leesburg, FL
National Provider Identifier
1437281102
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FLORIDA HEART & VASCULAR MULTI SPECIALTY GROUP, PA
Doing business as
Leesburg Family Medicine
Practice address
802 E Dixie Ave
Leesburg, FL 34748-6014
Phone
(352) 787-1324
Fax
(352) 360-0668
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Authorized official

Name
Regina Ingram
Title
Administrative Assistant
Phone
(352) 728-6808

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X

Addresses

Primary practice location

802 E Dixie Ave
Leesburg, FL 34748-6014

Mailing address

802 E Dixie Ave
Leesburg, FL 34748-6014
Phone (352) 728-6808

Other names 1

  • Leesburg Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Florida Heart Vascular Multi Specialty 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

802 E Dixie Ave
Leesburg, FL 34748
Phone (352) 787-1324

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1437281102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486014",
            "telephone_number": "352-728-6808",
            "fax_number": "352-728-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486014",
            "telephone_number": "352-787-1324",
            "fax_number": "352-360-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA HEART & VASCULAR MULTI SPECIALTY GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "REGINA",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "352-728-6808"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leesburg Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.