Provider Demographics
NPI:1083651913
Name:BRADENTON CARDIAC SURGEONS, PA
Entity type:Organization
Organization Name:BRADENTON CARDIAC SURGEONS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:A
Authorized Official - Last Name:TABAIE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:941-746-0221
Mailing Address - Street 1:300 RIVERSIDE DR E
Mailing Address - Street 2:SUITE# 2600
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1008
Mailing Address - Country:US
Mailing Address - Phone:941-746-0221
Mailing Address - Fax:941-750-0473
Practice Address - Street 1:300 RIVERSIDE DR E
Practice Address - Street 2:SUITE# 2600
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1008
Practice Address - Country:US
Practice Address - Phone:941-746-0221
Practice Address - Fax:941-750-0473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5710208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty