Healthcare Provider Details

I. General information

NPI: 1699889816
Provider Name (Legal Business Name): TAMPA HEART & VASCULAR ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 11/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 W DR MARTIN LUTHER KING JR BLVD STE 800
TAMPA FL
33607-6065
US

IV. Provider business mailing address

2727 W DR MARTIN LUTHER KING JR BLVD SUITE 800
TAMPA FL
33607-6065
US

V. Phone/Fax

Practice location:
  • Phone: 813-873-0000
  • Fax: 813-873-3659
Mailing address:
  • Phone: 813-873-0000
  • Fax: 813-873-3659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0014584
License Number StateFL

VIII. Authorized Official

Name: ORLANDO S RANGEL
Title or Position: PRESIDENT
Credential: MD
Phone: 813-873-0000