Healthcare Provider Details

I. General information

NPI: 1982871489
Provider Name (Legal Business Name): COMPREHENSIVE CARDIOVASCULAR CARE, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2219 GARFIELD ST
TWO RIVERS WI
54241-2416
US

IV. Provider business mailing address

PO BOX 2040
MILWAUKEE WI
53201-2040
US

V. Phone/Fax

Practice location:
  • Phone: 920-793-2281
  • Fax:
Mailing address:
  • Phone: 414-649-3530
  • Fax: 414-649-3529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEVE FRANCAVIGLIA
Title or Position: COO
Credential:
Phone: 414-649-3403