Healthcare Provider Details

I. General information

NPI: 1124252846
Provider Name (Legal Business Name): CARDIAC ARRHYTHMIA INSTITUTE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2009
Last Update Date: 05/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 E MARION AVE SUITE 135
PUNTA GORDA FL
33950-3872
US

IV. Provider business mailing address

PO BOX 510363
PUNTA GORDA FL
33951-0363
US

V. Phone/Fax

Practice location:
  • Phone: 941-205-2520
  • Fax: 941-894-6184
Mailing address:
  • Phone: 941-205-2520
  • Fax: 941-894-6184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME92434
License Number StateFL

VIII. Authorized Official

Name: SIDNEY PEYKAR
Title or Position: OWNER
Credential: MD
Phone: 941-205-2520