Provider Demographics
NPI:1508957846
Name:HEART CARE & VASCULAR MEDICINE P A
Entity Type:Organization
Organization Name:HEART CARE & VASCULAR MEDICINE P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:PARENTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-343-2255
Mailing Address - Street 1:2101 NIGHTINGALE LN
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-4365
Mailing Address - Country:US
Mailing Address - Phone:352-343-2255
Mailing Address - Fax:352-343-2510
Practice Address - Street 1:2101 NIGHTINGALE LN
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-4365
Practice Address - Country:US
Practice Address - Phone:352-343-2255
Practice Address - Fax:352-343-2510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME#67135207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26500OtherBCBS
FL376905400Medicaid
FLP00078003OtherRRMC
FLP00078003OtherRRMC
FL376905400Medicaid