Healthcare Provider Details

I. General information

NPI: 1508814906
Provider Name (Legal Business Name): VIVEK V KUMAR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9423 TOWN CENTER PKWY
LAKEWOOD RANCH FL
34202-5134
US

IV. Provider business mailing address

9423 TOWN CENTER PKWY
LAKEWOOD RANCH FL
34202-5134
US

V. Phone/Fax

Practice location:
  • Phone: 941-907-8951
  • Fax: 941-907-3015
Mailing address:
  • Phone: 941-907-8951
  • Fax: 941-907-3015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberOS13436
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberOS010177L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberOS13436
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: