Healthcare Provider Details

I. General information

NPI: 1982988978
Provider Name (Legal Business Name): ADVANCED CARE CARDIOLOGY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2011
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 HAND AVE STE R
ORMOND BEACH FL
32174-8196
US

IV. Provider business mailing address

1400 HAND AVE STE R
ORMOND BEACH FL
32174-8196
US

V. Phone/Fax

Practice location:
  • Phone: 386-677-7875
  • Fax: 386-672-8102
Mailing address:
  • Phone: 386-677-7875
  • Fax: 386-672-8102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ARTHUR W WILKINSON III
Title or Position: PRESIDENT
Credential: MD
Phone: 386-677-7875