Healthcare Provider Details

I. General information

NPI: 1891243549
Provider Name (Legal Business Name): CARDIOVASCULAR INTERVENTIONS OF MIAMI PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 SW 97TH AVE SUITE 208
MIAMI FL
33173-1494
US

IV. Provider business mailing address

7000 SW 97TH AVE SUITE 208
MIAMI FL
33173-1494
US

V. Phone/Fax

Practice location:
  • Phone: 305-227-7780
  • Fax: 305-278-3038
Mailing address:
  • Phone: 305-227-7780
  • Fax: 305-278-3038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE PERERA
Title or Position: BILLING MANAGER
Credential:
Phone: 305-227-7780