Provider Demographics
NPI:1104092394
Name:MOUNT SINAI CARDIO-PRICARE LLC
Entity type:Organization
Organization Name:MOUNT SINAI CARDIO-PRICARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:H
Authorized Official - Last Name:SEGALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-532-4502
Mailing Address - Street 1:4302 ALTON RD
Mailing Address - Street 2:750
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2891
Mailing Address - Country:US
Mailing Address - Phone:305-532-4502
Mailing Address - Fax:305-538-1487
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:750
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2891
Practice Address - Country:US
Practice Address - Phone:305-532-4502
Practice Address - Fax:305-538-1487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36230207R00000X
FLME30417207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty