Healthcare Provider Details

I. General information

NPI: 1679666598
Provider Name (Legal Business Name): CARDIOVASCULAR INSTITUTE OF CENTRAL FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 SW 20TH PLACE
OCALA FL
34471
US

IV. Provider business mailing address

2111 SW 20TH PLACE
OCALA FL
34471
US

V. Phone/Fax

Practice location:
  • Phone: 352-622-4251
  • Fax: 352-873-3920
Mailing address:
  • Phone: 352-622-4251
  • Fax: 352-873-3920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateFL

VIII. Authorized Official

Name: REY ESTEVAN
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 352-622-4251