Provider Demographics
NPI:1700329216
Name:CARDIOVASCULAR ADVANTAGES OF FLORIDA, LLC
Entity type:Organization
Organization Name:CARDIOVASCULAR ADVANTAGES OF FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR, COO
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LIEBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-446-8755
Mailing Address - Street 1:PO BOX 87159
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70879-8159
Mailing Address - Country:US
Mailing Address - Phone:407-446-8755
Mailing Address - Fax:877-885-9540
Practice Address - Street 1:4767 NEW BROAD ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6405
Practice Address - Country:US
Practice Address - Phone:407-446-8722
Practice Address - Fax:877-885-9540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center