Healthcare Provider Details

I. General information

NPI: 1942795000
Provider Name (Legal Business Name): ORLANDO HEART & VASCULAR INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 W CENTRAL PKWY
ALTAMONTE SPRINGS FL
32714-2436
US

IV. Provider business mailing address

450 W CENTRAL PKWY
ALTAMONTE SPRINGS FL
32714-2436
US

V. Phone/Fax

Practice location:
  • Phone: 407-767-8554
  • Fax: 407-767-9121
Mailing address:
  • Phone: 407-767-8554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NANDKISHORE VIJAY RANADIVE
Title or Position: PRESIDENT
Credential: MD
Phone: 321-946-0140