Healthcare Provider Details
I. General information
NPI: 1518932003
Provider Name (Legal Business Name): CARDIOVASCULAR CONSULTANTS OF IN. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2006
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7217 INDIANAPOLIS BLVD
HAMMOND IN
46324-2213
US
IV. Provider business mailing address
7217 INDIANAPOLIS BLVD
HAMMOND IN
46324-2213
US
V. Phone/Fax
- Phone: 219-554-4080
- Fax: 219-554-4085
- Phone: 219-554-4080
- Fax: 219-554-4085
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | 71000524A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SC0200X |
| Taxonomy | Critical Care Medicine Clinical Nurse Specialist |
| License Number | 28133002A |
| License Number State | IN |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | 01038128A |
| License Number State | IN |
VIII. Authorized Official
Name: DR.
RAMON
P.
LLOBET
Title or Position: PRESIDENT
Credential: M.D.
Phone: 219-554-4080