Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cardiovascular Center of America

Organization Vascular Surgery Physician · NPI 1063975175

Cardiovascular Center of America is a Vascular Surgery Physician in Lake City, Florida. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

404 NW Hall Of Fame Dr
Lake City, FL 32055-4833
Phone: (856) 335-5025
Fax: (856) 213-9269
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X

Record details

NPI number1063975175
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James O'Dare — Principal · (856) 335-5025
NPI enumeratedApril 8, 2019
Last updated in NPPESApril 8, 2019
Mailing address575 N Route 73 Ste A6, West Berlin, NJ 08091-2440