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General NPI Number Information
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NPI Number | 1083486518
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA CARDIOVASCULAR IMAGING CENTER, LLC
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Dates
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Enumeration Date | 10/27/2023
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 1717 MAYO DR
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City | TAVARES
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State | FL
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Zip | 32778-4307
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Country | US
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Telephone | 352-253-0003
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Fax | 352-253-0016
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Provider Business Mailing Address
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Address Line | 1691 MAYO DR
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City | TAVARES
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State | FL
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Zip | 32778-4301
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Country | US
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Telephone | 352-253-0003
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Fax | 352-253-0016
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Authorized Official
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Title or Position | OWNER
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Name | KEHINDE A LAYENI
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Credential |
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Telephone | 352-253-0003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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