Healthcare Provider Details

I. General information

NPI: 1467388363
Provider Name (Legal Business Name): PAX CARDIOVASCULAR SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 4TH AVE STE D
CRESTVIEW FL
32539-2401
US

IV. Provider business mailing address

4945 CASTAYLS
PENSACOLA FL
32504-9022
US

V. Phone/Fax

Practice location:
  • Phone: 850-281-3324
  • Fax:
Mailing address:
  • Phone: 850-281-3324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VISHAL GUJRAL
Title or Position: OWNER
Credential: MD
Phone: 850-281-3324