Provider Demographics
NPI:1215477674
Name:HEART OF FLORIDA CARDIOVASCULAR CENTER, LLC
Entity type:Organization
Organization Name:HEART OF FLORIDA CARDIOVASCULAR CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MANUBENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-516-0912
Mailing Address - Street 1:294 PATTERSON RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-6251
Mailing Address - Country:US
Mailing Address - Phone:863-438-7465
Mailing Address - Fax:863-438-7466
Practice Address - Street 1:294 PATTERSON RD
Practice Address - Street 2:SUITE B
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-6251
Practice Address - Country:US
Practice Address - Phone:863-438-7465
Practice Address - Fax:863-438-7466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center