Provider Demographics
NPI:1396134797
Name:CENTER FOR CARDIOVASCULAR EXCELLENCE FLORIDA SOUTH LLC
Entity type:Organization
Organization Name:CENTER FOR CARDIOVASCULAR EXCELLENCE FLORIDA SOUTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANDKISHORE
Authorized Official - Middle Name:
Authorized Official - Last Name:RANADIVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-930-6281
Mailing Address - Street 1:308 E HAZEL ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4023
Mailing Address - Country:US
Mailing Address - Phone:407-930-6281
Mailing Address - Fax:407-930-6294
Practice Address - Street 1:308 E HAZEL ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4023
Practice Address - Country:US
Practice Address - Phone:407-930-6281
Practice Address - Fax:407-930-6294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical