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General NPI Number Information
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NPI Number | 1184888950
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Entity Type | Organization
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Legal Business Name | FLORIDA CARDIAC CONSULTANTS, INC
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 463 CARLTON ST
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City | WAUCHULA
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State | FL
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Zip | 33873-3400
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Country | US
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Telephone | 863-767-0660
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 25377
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City | SARASOTA
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State | FL
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Zip | 34277
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Country | US
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Telephone | 941-917-0060
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARK SPETSIOS
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Credential |
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Telephone | 941-917-0060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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