Provider Demographics
NPI:1902605660
Name:ATLANTIC COAST CARDIOLOGY LLC
Entity type:Organization
Organization Name:ATLANTIC COAST CARDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD /OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:KANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-296-7775
Mailing Address - Street 1:8245 BAYBERRY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7432
Mailing Address - Country:US
Mailing Address - Phone:904-296-7775
Mailing Address - Fax:904-296-7760
Practice Address - Street 1:8245 BAYBERRY RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7432
Practice Address - Country:US
Practice Address - Phone:904-296-7775
Practice Address - Fax:904-296-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty