Healthcare Provider Details

I. General information

NPI: 1376637462
Provider Name (Legal Business Name): GERIATRIC HEARTS OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 11/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8410 W FLAGLER ST SUITE # 204
MIAMI FL
33144-2092
US

IV. Provider business mailing address

8410 W FLAGLER ST SUITE # 204
MIAMI FL
33144-2092
US

V. Phone/Fax

Practice location:
  • Phone: 786-273-1361
  • Fax: 305-274-0692
Mailing address:
  • Phone: 786-273-1361
  • Fax: 305-274-0692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JUAN CARLOS ABREU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 786-273-1361