Healthcare Provider Details

I. General information

NPI: 1992830731
Provider Name (Legal Business Name): HEALTH CENTRAL EKG SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11140 W COLONIAL DR STE 1
OCOEE FL
34761-3300
US

IV. Provider business mailing address

11140 W COLONIAL DR STE 1
OCOEE FL
34761-3300
US

V. Phone/Fax

Practice location:
  • Phone: 407-877-2111
  • Fax:
Mailing address:
  • Phone: 407-877-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS WENTZELL
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 407-877-2111