Healthcare Provider Details

I. General information

NPI: 1205887809
Provider Name (Legal Business Name): HEART SPECIALISTS OF SARASOTA PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 12/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 ARLINGTON ST SUITE 400
SARASOTA FL
34239-3513
US

IV. Provider business mailing address

1950 ARLINGTON ST SUITE 400
SARASOTA FL
34239-3513
US

V. Phone/Fax

Practice location:
  • Phone: 941-917-4250
  • Fax: 941-917-4257
Mailing address:
  • Phone: 941-917-4250
  • Fax: 941-917-4257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE ARCHAMBAULT
Title or Position: OFFICE MANAGER
Credential: CPC
Phone: 941-225-6006