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CHARLOTTE HEART & VASCULAR CENTER
NPI 1477266971
Internal Medicine - Cardiovascular Disease in Port Charlotte, FL

Active since December 29, 2022CLIA 10D2276177 · Waiver
1620 TAMIAMI TRAIL, SUITE 308, PORT CHARLOTTE, FL 33948(941) 246-2482(941) 979-9074 Get Directions Write a Review

NPPES record last updated: November 3, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 3, 2025, Dec 29, 2022 (2 updates tracked since 2022).

About Charlotte Heart & Vascular Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLOTTE HEART & VASCULAR CENTER (NPI 1477266971) is a healthcare organization registered as a cardiovascular disease in Port Charlotte, Florida and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through February 2, 2027 and lists Mario J Lopez, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1477266971
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameCHARLOTTE HEART & VASCULAR CENTER
Location Address1620 TAMIAMI TRAIL, SUITE 308Port Charlotte, FL 33948-4017
Mailing Address1620 Tamiami Trail, Suite 308Port Charlotte, FL 33948-4017 · (941) 246-2482 · Fax (941) 979-9074
Phone(941) 246-2482
Fax(941) 979-9074
Organization SubpartNo
Authorized OfficialMario J LopezOwner/physician · (941) 246-2482
Enumeration DateDecember 29, 2022
Last NPPES UpdateNovember 3, 20252 updates tracked since enumeration
NPPES CertifiedNovember 3, 2025
✔ NPI 1477266971 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
1620 TAMIAMI TRAIL, Port Charlotte, FL 33948
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Charlotte Heart & Vascular Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Charlotte Heart & Vascular Center, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Kristin Garcia-Miller, APRN
Nurse Practitioner
NPI 1770966335
1620 TAMIAMI TRAIL SUITE 308
Port Charlotte, FL 33948
(941) 246-2482
✔ PECOS✔ Accepts MedicareSame address
Alexandra Kitchener, APRN
Nurse Practitioner
NPI 1629616552
1620 TAMIAMI TRAIL SUITE 308
Port Charlotte, FL 33948
(941) 246-2482
✔ PECOS✔ Accepts MedicareSame address
Mario Lopez, MD
Cardiovascular Disease (Cardiology)
NPI 1710990882
1620 TAMIAMI TRAIL SUITE 308
Port Charlotte, FL 33948
(941) 246-2482
✔ PECOS✔ Accepts MedicareSame address
Karen Rudolph, APRN
Nurse Practitioner
NPI 1346567674
22395 EDGEWATER DR
Port Charlotte, FL 33980
(941) 766-7222
✔ PECOS4.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2276177

Charlotte Heart And Vascular Center · Port Charlotte, FL
Active · expires Feb 2, 2027
CLIA Number10D2276177
Laboratory TypePhysician Office
Certificate Effective DateFebruary 3, 2025
Certificate Expiration DateFebruary 2, 2027
Laboratory DirectorMario J. Lopez
Laboratory Phone(941) 246-2482
Laboratory LocationCharlotte Heart And Vascular Center1620 Tamiami Trail - Ste 308, Port Charlotte, FL 33948
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charlotte Heart & Vascular Center's NPI number?

The NPI number for Charlotte Heart & Vascular Center is 1477266971. It was assigned to this organization in the NPPES registry on December 29, 2022.

Where is Charlotte Heart & Vascular Center located?

Charlotte Heart & Vascular Center is located at 1620 Tamiami Trail Suite 308, Port Charlotte, FL 33948. The listed phone number is (941) 246-2482.

What is Charlotte Heart & Vascular Center's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Charlotte Heart & Vascular Center enrolled in Medicare?

Yes. Charlotte Heart & Vascular Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Charlotte Heart & Vascular Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Charlotte Heart & Vascular Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3) and Cardiovascular Disease (Cardiology) (1). Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Charlotte Heart & Vascular Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2276177) is associated with this NPI, valid through February 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Charlotte Heart & Vascular Center was last updated on November 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.