Healthcare Provider Details

I. General information

NPI: 1821093220
Provider Name (Legal Business Name): CARDIAC SURGICAL ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 05/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6006 49TH ST N STE 310
ST PETERSBURG FL
33709-2149
US

IV. Provider business mailing address

6006 49TH ST N STE 310
ST PETERSBURG FL
33709-2149
US

V. Phone/Fax

Practice location:
  • Phone: 727-527-9779
  • Fax: 727-522-0415
Mailing address:
  • Phone: 727-527-9779
  • Fax: 727-522-0415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: MONIQUE PATRICK
Title or Position: PRACTICE MANAGER
Credential:
Phone: 727-527-9779