Healthcare Provider Details

I. General information

NPI: 1568372647
Provider Name (Legal Business Name): FLORIDA CARDIAC HEALTH MEDICAL GROUP, P.A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 BERNARDO AVE
MOUNTAIN VIEW CA
94043-5138
US

IV. Provider business mailing address

189 BERNARDO AVE
MOUNTAIN VIEW CA
94043-5138
US

V. Phone/Fax

Practice location:
  • Phone: 206-816-0809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER KOZLOWSKI
Title or Position: OWNER
Credential: MD
Phone: 206-816-0809