| Premier Heart And Vascular Center, Pa | |
|
38035 Medical Center Avenue Zephyrhills FL 33539 | |
| (813) 788-1400 | |
| (813) 788-7691 |
| Full Name | Premier Heart And Vascular Center, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 38035 Medical Center Avenue, Zephyrhills, Florida |
| Authorized Official Name and Position | Sunil Gupta (PARTNER) |
| Authorized Official Contact | 8137881400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Heart And Vascular Center, Pa Po Box 2709 Zephyrhills FL 33539-2709 Ph: (813) 788-1400 | Premier Heart And Vascular Center, Pa 38035 Medical Center Avenue Zephyrhills FL 33539 Ph: (813) 788-1400 |
| NPI Number | 1417060229 |
|---|---|
| Provider Enumeration Date | 08/16/2006 |
| Last Update Date | 05/17/2018 |
| Medicare PECOS PAC ID | 0648288225 |
|---|---|
| Medicare Enrollment ID | O20060323000201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417060229 | NPI | - | NPPES |
| 257622800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME78413 (Florida) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | ME78413 (Florida) | Primary |
| Provider Name | Sunil Gupta |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1508979311 PECOS PAC ID: 5193777076 Enrollment ID: I20050218000640 |
| Provider Name | Huy D Khuu |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1922043157 PECOS PAC ID: 1850329533 Enrollment ID: I20050803000290 |
| Provider Name | Ketul Chauhan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356430623 PECOS PAC ID: 1052405040 Enrollment ID: I20070921000240 |
| Provider Name | Chetan Khamare |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871783217 PECOS PAC ID: 9638356850 Enrollment ID: I20121005000289 |
| Provider Name | Vikas R Soma |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1326095894 PECOS PAC ID: 8729099825 Enrollment ID: I20141126000576 |
| Provider Name | Iosif Kelesidis |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1013154111 PECOS PAC ID: 7911212436 Enrollment ID: I20170426002731 |
| Provider Name | Morgan Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427565340 PECOS PAC ID: 7911339585 Enrollment ID: I20191120000763 |
| Provider Name | Rahul S Thomas |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1447540471 PECOS PAC ID: 9032484746 Enrollment ID: I20210407000295 |
| Provider Name | Vivek Sengupta |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679988802 PECOS PAC ID: 6507176724 Enrollment ID: I20210519001476 |
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