Provider Demographics
NPI:1558316604
Name:FLORIDA CARDIOLOGY GROUP PA
Entity type:Organization
Organization Name:FLORIDA CARDIOLOGY GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLEGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-641-7825
Mailing Address - Street 1:110 JOHN F KENNEDY DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1146
Mailing Address - Country:US
Mailing Address - Phone:561-641-7825
Mailing Address - Fax:561-641-3748
Practice Address - Street 1:110 JOHN F KENNEDY DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1146
Practice Address - Country:US
Practice Address - Phone:561-641-7825
Practice Address - Fax:561-641-3748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty