Healthcare Provider Details

I. General information

NPI: 1033119656
Provider Name (Legal Business Name): SOUTH FLORIDA INTERNATIONAL CARDIOLOGY CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 BISCAYNE BLVD 3RD FL
MIAMI FL
33137-9800
US

IV. Provider business mailing address

3801 BISCAYNE BLVD 3RD FL
MIAMI FL
33137-9800
US

V. Phone/Fax

Practice location:
  • Phone: 305-571-0620
  • Fax: 305-576-0919
Mailing address:
  • Phone: 305-571-0620
  • Fax: 305-576-0919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateFL
# 8
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: KEVIN M COY
Title or Position: PRESIDENT
Credential: MD
Phone: 305-571-0620