Provider Demographics
NPI:1013044726
Name:CENTRAL FLORIDA HEART GROUP P.A.
Entity Type:Organization
Organization Name:CENTRAL FLORIDA HEART GROUP P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLAVENTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-237-4116
Mailing Address - Street 1:6600 SW HWY 200
Mailing Address - Street 2:SUITE # 300
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476
Mailing Address - Country:US
Mailing Address - Phone:352-237-4116
Mailing Address - Fax:
Practice Address - Street 1:6600 SW HWY 200
Practice Address - Street 2:SUITE 300
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476
Practice Address - Country:US
Practice Address - Phone:352-237-4116
Practice Address - Fax:352-237-1785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL51646ZOtherBCBS GROUP ID #
FL51646ZOtherBCBS GROUP ID #