Provider Demographics
NPI:1518137827
Name:WEST FLORIDA CARDIOVASCULAR CENTER
Entity Type:Organization
Organization Name:WEST FLORIDA CARDIOVASCULAR CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIMESH
Authorized Official - Middle Name:K
Authorized Official - Last Name:MITHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-786-1000
Mailing Address - Street 1:P O BOX 1746
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34682-1746
Mailing Address - Country:US
Mailing Address - Phone:727-786-1000
Mailing Address - Fax:727-786-1055
Practice Address - Street 1:2676 W LAKE RD
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3120
Practice Address - Country:US
Practice Address - Phone:727-786-1000
Practice Address - Fax:727-786-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93842207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty