Provider Demographics
NPI:1124209085
Name:CARDIAC & VASCULAR SURGERY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:CARDIAC & VASCULAR SURGERY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:V
Authorized Official - Last Name:CAGGIANO
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:352-378-7544
Mailing Address - Street 1:1100 NW 8TH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-2916
Mailing Address - Country:US
Mailing Address - Phone:352-378-7544
Mailing Address - Fax:352-378-7067
Practice Address - Street 1:1100 NW 8TH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-2916
Practice Address - Country:US
Practice Address - Phone:352-378-7544
Practice Address - Fax:352-378-7067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54586208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11884OtherBLUE CROSS BLUE SHIELD
FL268510800Medicaid
FLK5308OtherMEDICARE GROUP #
FL1790797421OtherMEDICARE INDIVIDUAL NPI
FL207843OtherAVMED
FLE45095Medicare UPIN