Healthcare Provider Details

I. General information

NPI: 1659072502
Provider Name (Legal Business Name): FLORIDA CARDIOLOGY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2023
Last Update Date: 03/16/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139111 LAKESHORE BLVD UNIT 112
HUDSON FL
34667-7102
US

IV. Provider business mailing address

2410 NORTHSIDE DR
CLEARWATER FL
33761-2236
US

V. Phone/Fax

Practice location:
  • Phone: 727-848-6400
  • Fax:
Mailing address:
  • Phone: 727-499-0351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SUDHIR AGARWAL
Title or Position: OWNER
Credential: MD
Phone: 727-848-6400