Healthcare Provider Details

I. General information

NPI: 1245257005
Provider Name (Legal Business Name): CARDIOLOGY AND INTERNAL MEDICINE GROUP OF NORTH FLORIDA P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 AVENUE E
APALACHICOLA FL
32320-2069
US

IV. Provider business mailing address

7100 HOLLYWOOD BLVD SUITE 23
PEMBROKE PINES FL
33024-7355
US

V. Phone/Fax

Practice location:
  • Phone: 850-653-4134
  • Fax: 850-653-4135
Mailing address:
  • Phone: 954-967-0107
  • Fax: 850-653-4135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HELEN NITSIOS
Title or Position: OWNER
Credential: M.D.
Phone: 850-653-4134