Healthcare Provider Details

I. General information

NPI: 1881448512
Provider Name (Legal Business Name): FLORIDA CARDIAC HEALTH MEDICAL GROUP, P.A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 08/02/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 BIRD RD UNIT 650
MIAMI FL
33155-3708
US

IV. Provider business mailing address

1105 RIDGECREST DR
DICKSON TN
37055-6003
US

V. Phone/Fax

Practice location:
  • Phone: 855-338-8800
  • Fax:
Mailing address:
  • Phone: 615-474-3314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAURA PURDY
Title or Position: CEO, CFO, PRESIDENT, SECRATARY
Credential:
Phone: 855-338-8800