Provider Demographics
NPI:1568289130
Name:ADVANCED CARDIOVASCULAR CARE PLLC
Entity type:Organization
Organization Name:ADVANCED CARDIOVASCULAR CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LUZ
Authorized Official - Last Name:AVARICIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-270-1967
Mailing Address - Street 1:102 NE 2ND ST STE 238
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3908
Mailing Address - Country:US
Mailing Address - Phone:646-270-1967
Mailing Address - Fax:
Practice Address - Street 1:2233 PARK AVE STE 201A
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5567
Practice Address - Country:US
Practice Address - Phone:646-270-1967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty