Healthcare Provider Details

I. General information

NPI: 1124209085
Provider Name (Legal Business Name): CARDIAC & VASCULAR SURGERY ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 11/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NW 8TH AVE SUITE B
GAINESVILLE FL
32601-2916
US

IV. Provider business mailing address

1100 NW 8TH AVE SUITE B
GAINESVILLE FL
32601-2916
US

V. Phone/Fax

Practice location:
  • Phone: 352-378-7544
  • Fax: 352-378-7067
Mailing address:
  • Phone: 352-378-7544
  • Fax: 352-378-7067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberME54586
License Number StateFL

VIII. Authorized Official

Name: DR. ANTHONY V. CAGGIANO SR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 352-378-7544