Provider Demographics
NPI:1043253826
Name:VENICE CARDIOVASCULAR ANESTHESIA ASSOCIATES PLLC
Entity Type:Organization
Organization Name:VENICE CARDIOVASCULAR ANESTHESIA ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:C
Authorized Official - Last Name:PALMIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-433-2825
Mailing Address - Street 1:150 SE 17TH ST STE 503
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5176
Mailing Address - Country:US
Mailing Address - Phone:352-433-2825
Mailing Address - Fax:352-433-2893
Practice Address - Street 1:540 THE RIALTO
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2900
Practice Address - Country:US
Practice Address - Phone:352-433-2825
Practice Address - Fax:352-433-2893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268014900Medicaid
FL34679OtherBCBS OF FLORIDA
FL268014900Medicaid
FL34679Medicare PIN