Provider Demographics
NPI:1295975803
Name:INSTITUTE OF CARDIOVASCULAR EXCELLENCE PLLC
Entity type:Organization
Organization Name:INSTITUTE OF CARDIOVASCULAR EXCELLENCE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASAD
Authorized Official - Middle Name:U
Authorized Official - Last Name:QAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-854-0681
Mailing Address - Street 1:4730 SW 49TH RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6262
Mailing Address - Country:US
Mailing Address - Phone:352-854-0681
Mailing Address - Fax:352-854-8031
Practice Address - Street 1:4730 SW 49TH RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6262
Practice Address - Country:US
Practice Address - Phone:352-854-0681
Practice Address - Fax:352-854-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 207R00000X, 207RC0000X
FLME99096207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001305600Medicaid
FL000CEOtherBCBS OF FLORIDA
FL=========OtherEIN
FL001305600Medicaid