Florida Heart & Vascular Care, PLLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

FLORIDA HEART & VASCULAR CARE, PLLC

Practice address

120 Cypress Edge Dr
Suite 203
Palm Coast, FL 32164-8453

Phone

(386) 586-4410

NPI assigned

Jan 18, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Karen Christiane Theilade, M.D.

Title

Executive Director

Phone

(386) 237-7353

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380499200000",
    "number": "1669710141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 PALM COAST RESORT BLVD",
            "address_2": "SUITE 806",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321371812",
            "telephone_number": "615-400-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CYPRESS EDGE DR",
            "address_2": "SUITE 203",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321648453",
            "telephone_number": "386-586-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA HEART & VASCULAR CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-18",
        "last_updated": "2013-09-30",
        "status": "A",
        "authorized_official_last_name": "THEILADE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "CHRISTIANE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "386-237-7353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0046G",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008378300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "DT6579",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florida Em-I Medical Services PA
• Florida Family Dentistry P.a.
• Florida Health Care Plan Inc
• Florida Health Care Plan Inc
• Florida Healthcare Pharmacy
• Florida Hospital Flagler
• Florida Institute of Pain Medicine LLC
• Florida Oncology Network PA
• Florida Primary Care and Sports Medicine, Inc.
• Florida Sedation, Implant and Dental Surgery Associates, LLC

• Cardiovascular Disease Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.