Provider Demographics
NPI:1063967149
Name:TRI-COUNTY HEART INSTITUTE PA
Entity type:Organization
Organization Name:TRI-COUNTY HEART INSTITUTE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ-TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-504-3500
Mailing Address - Street 1:1400 N US HIGHWAY 441 STE 531
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-8985
Mailing Address - Country:US
Mailing Address - Phone:352-504-3500
Mailing Address - Fax:352-504-3388
Practice Address - Street 1:1400 N US HIGHWAY 441 STE 531
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-8985
Practice Address - Country:US
Practice Address - Phone:352-504-3500
Practice Address - Fax:352-504-3388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108879174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1659491983OtherINDIVIDUAL NPI
FL1346837895OtherINDIVIDUAL NPI
FL1457793978OtherINDIVIDUAL NPI