Provider Demographics
NPI:1790843332
Name:CARDIOVASCULAR INTERVENTIONS PA
Entity Type:Organization
Organization Name:CARDIOVASCULAR INTERVENTIONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PRADIP
Authorized Official - Middle Name:K
Authorized Official - Last Name:JAMNADAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-894-4880
Mailing Address - Street 1:1900 N MILLS AVE
Mailing Address - Street 2:107
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1444
Mailing Address - Country:US
Mailing Address - Phone:407-894-4880
Mailing Address - Fax:407-894-2364
Practice Address - Street 1:1900 N MILLS AVE
Practice Address - Street 2:107
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1444
Practice Address - Country:US
Practice Address - Phone:407-894-4880
Practice Address - Fax:407-894-2364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0054920174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6158910001Medicare NSC
FL00158Medicare ID - Type Unspecified