Healthcare Provider Details

I. General information

NPI: 1861987836
Provider Name (Legal Business Name): HEART HEALTH ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 05/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7369 SHERIDAN ST STE 300
HOLLYWOOD FL
33024-2776
US

IV. Provider business mailing address

7369 SHERIDAN ST STE 300
HOLLYWOOD FL
33024-2776
US

V. Phone/Fax

Practice location:
  • Phone: 954-451-5932
  • Fax: 954-947-4351
Mailing address:
  • Phone: 954-451-5932
  • Fax: 954-947-4351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME118805
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. YORDANKA I REYNA
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 954-451-5932