Healthcare Provider Details

I. General information

NPI: 1649769357
Provider Name (Legal Business Name): HEART & RHYTHM ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 05/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 STATE AVE STE 104
PANAMA CITY FL
32405-4539
US

IV. Provider business mailing address

2202 STATE AVE STE 104
PANAMA CITY FL
32405-4539
US

V. Phone/Fax

Practice location:
  • Phone: 850-763-8776
  • Fax:
Mailing address:
  • Phone: 850-763-8776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME85604
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME85604
License Number StateFL

VIII. Authorized Official

Name: DR. HARI K. BADDIGAM
Title or Position: AMBR
Credential: M.D., F.A.C.C.
Phone: 850-763-8776