Provider Demographics
NPI:1457166571
Name:CARDIOVASCULAR INSTITUTE OF CENTRAL FLORIDA, LLC
Entity type:Organization
Organization Name:CARDIOVASCULAR INSTITUTE OF CENTRAL FLORIDA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARDLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-622-4251
Mailing Address - Street 1:2111 SW 20TH PL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7734
Mailing Address - Country:US
Mailing Address - Phone:352-622-4251
Mailing Address - Fax:352-622-0102
Practice Address - Street 1:6511 SW HIGHWAY 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476
Practice Address - Country:US
Practice Address - Phone:352-622-4251
Practice Address - Fax:352-622-0102
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARDIOVASCULAR INSTITUTE OF CENTRAL FLORIDA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-07
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac FacilitiesGroup - Multi-Specialty
No163WC3500XNursing Service ProvidersRegistered NurseCardiac RehabilitationGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No2471C1106XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistCardiac-Interventional TechnologyGroup - Multi-Specialty