Healthcare Provider Details

I. General information

NPI: 1366487878
Provider Name (Legal Business Name): STUART CARDIOVASCULAR ANESTHESIA ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 SE OSCEOLA ST SUITE 100
STUART FL
34994-2322
US

IV. Provider business mailing address

PO BOX 3130
OCALA FL
34478-3130
US

V. Phone/Fax

Practice location:
  • Phone: 772-419-2379
  • Fax: 772-419-2377
Mailing address:
  • Phone: 352-867-8311
  • Fax: 352-867-1053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: VINCENT C PALMIRE
Title or Position: PARTNER
Credential: MD
Phone: 352-867-8311