Provider Demographics
NPI:1457869331
Name:CARDIAC CIN OF WEST PALM LLC
Entity type:Organization
Organization Name:CARDIAC CIN OF WEST PALM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NPI OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DEEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-722-1062
Mailing Address - Street 1:102 WOODMONT BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2216
Mailing Address - Country:US
Mailing Address - Phone:615-386-0064
Mailing Address - Fax:615-386-0067
Practice Address - Street 1:4440 PGA BLVD # 600C
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6539
Practice Address - Country:US
Practice Address - Phone:615-386-0064
Practice Address - Fax:615-386-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-13
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty