Provider Demographics
NPI:1164726899
Name:GLOBAL FITNESS INITIATIVE
Entity Type:Organization
Organization Name:GLOBAL FITNESS INITIATIVE
Other - Org Name:THE HEALTHY HEART CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WALI
Authorized Official - Middle Name:
Authorized Official - Last Name:GAUVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-485-0470
Mailing Address - Street 1:14130 NOBLEWOOD PLZ
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-1464
Mailing Address - Country:US
Mailing Address - Phone:703-485-0470
Mailing Address - Fax:877-755-3396
Practice Address - Street 1:14130 NOBLEWOOD PLZ
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-1464
Practice Address - Country:US
Practice Address - Phone:703-485-0470
Practice Address - Fax:877-755-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012420652080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty