Healthcare Provider Details

I. General information

NPI: 1821296187
Provider Name (Legal Business Name): CARDIOVASCULAR SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7806 LAKE UNDERHILL RD SUITE 104
ORLANDO FL
32822-8232
US

IV. Provider business mailing address

PO BOX 690358
ORLANDO FL
32869-0358
US

V. Phone/Fax

Practice location:
  • Phone: 407-249-3005
  • Fax: 407-249-3006
Mailing address:
  • Phone: 407-249-3005
  • Fax: 407-249-3006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SYED IMRAN ALI
Title or Position: OWNER
Credential: M.D.
Phone: 407-249-3005