MEDICARE: CARDIO MDM MSO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1093690794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIO MDM MSO LLC

Provider Business Mailing Address
First Line	:	7100 W 20TH AVE STE 205
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-1812
Country	:	US
Telephone Number	:	305-824-3451
Fax Number	:	855-340-0733

Provider Business Practice Location Address
First Line	:	7100 W 20TH AVE STE 205
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-1812
Country	:	US
Telephone Number	:	305-824-3451
Fax Number	:	855-340-0733

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	PILAR LOIZ
Credential	:
Telephone Number	:	305-824-3451

Provider Enumeration Date	:	08/11/2025
Last Update Date	:	04/07/2026

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Directions to “CARDIO MDM MSO LLC ” Practice Location

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