Healthcare Provider Details

I. General information

NPI: 1477633964
Provider Name (Legal Business Name): CARDIOVASCULAR SPECIALTY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 W FLAGLER ST SUITE 100
CORAL GABLES FL
33134-1608
US

IV. Provider business mailing address

3900 W FLAGLER ST SUITE 100
CORAL GABLES FL
33134-1608
US

V. Phone/Fax

Practice location:
  • Phone: 305-529-9304
  • Fax: 305-529-9316
Mailing address:
  • Phone: 305-529-9304
  • Fax: 305-529-9316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. ALBERTO G SANTAMARINA
Title or Position: PRESIDENT
Credential: MD
Phone: 305-642-3724