Healthcare Provider Details

I. General information

NPI: 1669405379
Provider Name (Legal Business Name): CITRUS CARDIOLOGY CONSULTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 W HIGHLAND BLVD
INVERNESS FL
34452-4716
US

IV. Provider business mailing address

308 W HIGHLAND BLVD
INVERNESS FL
34452-4716
US

V. Phone/Fax

Practice location:
  • Phone: 352-726-8353
  • Fax: 352-726-5038
Mailing address:
  • Phone: 352-726-8353
  • Fax: 352-726-5038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: NISHANT NERELLA
Title or Position: PRESIDENT
Credential: MD
Phone: 352-726-8353