Provider Demographics
NPI:1952907800
Name:FLORIDA HEARTS LLC
Entity type:Organization
Organization Name:FLORIDA HEARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLAVENTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-414-2270
Mailing Address - Street 1:6600 SW HIGHWAY 200 STE 300
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-5554
Mailing Address - Country:US
Mailing Address - Phone:352-237-4116
Mailing Address - Fax:
Practice Address - Street 1:6600 SW HIGHWAY 200 STE 300
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-5554
Practice Address - Country:US
Practice Address - Phone:352-237-4116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PANACEA HEALTH SYSTEMS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty