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General NPI Number Information
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NPI Number | 1083908057
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Entity Type | Organization
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Legal Business Name | CENTER FOR ADVANCE CARDIOVASCULAR MEDICINE, PLLC
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 05/15/2018
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Provider Practice Location Address
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Address Line | 4849 LAKE WORTH RD SUITE 201
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City | GREENACRES
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State | FL
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Zip | 33463
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Country | US
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Telephone | 561-629-7267
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Fax |
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Provider Business Mailing Address
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Address Line | 1615 S CONGRESS AVE STE 103
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City | DELRAY BEACH
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State | FL
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Zip | 33445-6326
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Country | US
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Telephone | 561-245-9085
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Fax | 561-967-0167
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MOISE W ANGLADE
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Credential | M.D.
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Telephone | 561-629-7267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State | FL
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