Healthcare Provider Details

I. General information

NPI: 1518978626
Provider Name (Legal Business Name): CARDIOLOGY PARTNERS PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 01/12/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3347 STATE ROAD 7 STE 203
WELLINGTON FL
33449-8095
US

IV. Provider business mailing address

3345 BURNS RD STE 105
PALM BEACH GARDENS FL
33410-4304
US

V. Phone/Fax

Practice location:
  • Phone: 561-793-6100
  • Fax: 561-793-1974
Mailing address:
  • Phone: 561-626-1881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHANDRA VENUGOPAL
Title or Position: PRESIDENT
Credential: MD
Phone: 561-793-6100