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General NPI Number Information
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NPI Number | 1275639478
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Entity Type | Organization
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Legal Business Name | THE CARDIOVASCULAR CENTER, P.A.
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 910 WILLISTON PARK PT STE 1000
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City | LAKE MARY
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State | FL
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Zip | 32746-2172
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Country | US
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Telephone | 407-833-8028
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Fax | 407-833-8033
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Provider Business Mailing Address
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Address Line | 910 WILLISTON PARK PT STE 1000
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City | LAKE MARY
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State | FL
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Zip | 32746-2172
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Country | US
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Telephone | 407-833-8028
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Fax | 407-833-8033
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | CHRIS BILLETTE
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Credential |
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Telephone | 407-833-8028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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