| Florida Heart & Vascular Center | |
|
511 Medical Plaza Dr Suite 101 Leesburg FL 34748-7326 | |
| (352) 728-6808 | |
| (352) 728-1743 |
| Full Name | Florida Heart & Vascular Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 511 Medical Plaza Dr, Leesburg, Florida |
| Authorized Official Name and Position | Jackie Faunda (PHYSICIAN CREDENTIALING) |
| Authorized Official Contact | 3527286808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Florida Heart & Vascular Center 511 Medical Plaza Dr Suite 101 Leesburg FL 34748-7326 Ph: (352) 728-6808 | Florida Heart & Vascular Center 511 Medical Plaza Dr Suite 101 Leesburg FL 34748-7326 Ph: (352) 728-6808 |
| NPI Number | 1699769042 |
|---|---|
| Provider Enumeration Date | 08/31/2005 |
| Last Update Date | 09/13/2013 |
| Medicare PECOS PAC ID | 6507839735 |
|---|---|
| Medicare Enrollment ID | O20040817000130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699769042 | NPI | - | NPPES |
| 21798 | Other | FL | BCBS FLORIDA |
| 255260400 | Medicaid | FL | |
| 773114 | Other | MAILHANDLERS | |
| 695956 | Other | TUFTS | |
| CN9333 | Other | GBA RR PALMETTO | |
| 7914953 | Other | MAMSI |
| Provider Name | Patrick J Fullerton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811039555 PECOS PAC ID: 2668371857 Enrollment ID: I20041231000020 |
| Provider Name | Tanya Diaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467445080 PECOS PAC ID: 1759339922 Enrollment ID: I20050105000408 |
| Provider Name | David Sustarsic |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134183130 PECOS PAC ID: 8921013277 Enrollment ID: I20060814000036 |
| Provider Name | Michael S Frasure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841380623 PECOS PAC ID: 0547269045 Enrollment ID: I20061211000489 |
| Provider Name | Larry D Foster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477559060 PECOS PAC ID: 6406759539 Enrollment ID: I20070120000072 |
| Provider Name | Jeffrey Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790781391 PECOS PAC ID: 8426951559 Enrollment ID: I20070122000237 |
| Provider Name | Maria B Bello |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821081563 PECOS PAC ID: 6002918828 Enrollment ID: I20070226000557 |
| Provider Name | John Richard Hurt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093710790 PECOS PAC ID: 6406757988 Enrollment ID: I20070307000195 |
| Provider Name | Joseph Sahab |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346233772 PECOS PAC ID: 1153464870 Enrollment ID: I20100203000661 |
| Provider Name | David C Lew |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861485757 PECOS PAC ID: 5698776524 Enrollment ID: I20100507000799 |
| Provider Name | Jose R Rosado |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417940404 PECOS PAC ID: 4789685611 Enrollment ID: I20101008000871 |
| Provider Name | Michael A Glick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275572893 PECOS PAC ID: 0547227761 Enrollment ID: I20101124000545 |
| Provider Name | Marwan Mihyu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609171180 PECOS PAC ID: 7416136338 Enrollment ID: I20110125000457 |
| Provider Name | Kenneth C Obiaja |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639342363 PECOS PAC ID: 4082883335 Enrollment ID: I20110803000461 |
| Provider Name | Florian Gegaj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205099660 PECOS PAC ID: 9638341373 Enrollment ID: I20110930000524 |
| Provider Name | Robert H Swietarski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790763332 PECOS PAC ID: 3274503115 Enrollment ID: I20121010000042 |
| Provider Name | Deborah Pate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942552997 PECOS PAC ID: 1759534126 Enrollment ID: I20130115000153 |
| Provider Name | Robert Aisenstat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497798318 PECOS PAC ID: 4082633326 Enrollment ID: I20130801000033 |
| Provider Name | Jonathan A Higgins |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1548426356 PECOS PAC ID: 5193969780 Enrollment ID: I20130923000006 |
| Provider Name | Romita Mukerjee |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1861669681 PECOS PAC ID: 4789811779 Enrollment ID: I20131219000860 |
| Provider Name | Kevin T Claudeanos |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1437314598 PECOS PAC ID: 8527216209 Enrollment ID: I20140904002581 |
| Provider Name | Kari Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447702717 PECOS PAC ID: 7214214774 Enrollment ID: I20170510001721 |
| Provider Name | John S Hayes |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154520476 PECOS PAC ID: 1254581549 Enrollment ID: I20170717003181 |
| Provider Name | Justin P Morgan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487188637 PECOS PAC ID: 2961774278 Enrollment ID: I20170822001534 |
| Provider Name | Ronald Torregosa Garcia |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750667580 PECOS PAC ID: 6901050558 Enrollment ID: I20171020002547 |
| Provider Name | Ingrid K Calliste |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083920383 PECOS PAC ID: 5698992998 Enrollment ID: I20180606001932 |
| Provider Name | Henry C Veldenz |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1649279431 PECOS PAC ID: 3173663655 Enrollment ID: I20190124001784 |
| Provider Name | Garrett H Brown |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1588001432 PECOS PAC ID: 2163665696 Enrollment ID: I20190129001186 |
| Provider Name | Angela L Tatro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821553827 PECOS PAC ID: 9133468838 Enrollment ID: I20190225000703 |
| Provider Name | Renee Gabriel Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104127059 PECOS PAC ID: 5890036933 Enrollment ID: I20190418000051 |
| Provider Name | Robert B Gibson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962848382 PECOS PAC ID: 7810125606 Enrollment ID: I20190613000544 |
| Provider Name | Prakrut H Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245593987 PECOS PAC ID: 6507102423 Enrollment ID: I20190717001119 |
| Provider Name | Natalie Lam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811523103 PECOS PAC ID: 3476983032 Enrollment ID: I20200422001195 |
| Provider Name | Bobbi Rhae Armbruster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205493327 PECOS PAC ID: 8527498757 Enrollment ID: I20200430001184 |
| Provider Name | Ahmed Mahmoud |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942649694 PECOS PAC ID: 8426291097 Enrollment ID: I20211216000196 |
| Provider Name | Kelvin Ong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275038283 PECOS PAC ID: 7315338001 Enrollment ID: I20220107001047 |
| Provider Name | Maria Baldasare |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1790914372 PECOS PAC ID: 6103040472 Enrollment ID: I20220404002308 |
Centerwell Senior Primary Care (fl) Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 941 N 14th St, Leesburg, FL 34748 Phone: 352-326-4031 Fax: 352-360-0257 | |
Lake Internal Medicine Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 293 Bent Oak Ct, Leesburg, FL 34748 Phone: 352-408-9935 | |
Internal Medicine Of Central Florida Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 708 Physicians Ct, Suite 1, Leesburg, FL 34748 Phone: 352-504-0381 Fax: 352-315-1989 | |
Hawk & Puglia Family Practice Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 S 11th St, Suite 4, Leesburg, FL 34748 Phone: 352-787-8301 Fax: 352-787-6091 | |
Kenneth Appah Sampong, P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 709 Physicians Ct, Leesburg, FL 34748 Phone: 352-728-5116 Fax: 352-728-5928 | |
Community Health Centers, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 N 1st St, Leesburg, FL 34748 Phone: 407-905-8827 Fax: 352-360-0762 | |
Shakti Narain Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1070 Flagler Ave, Leesburg, FL 34748 Phone: 352-365-2550 Fax: 352-365-1950 |