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General NPI Number Information
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NPI Number | 1215238563
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Entity Type | Organization
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Legal Business Name | HEART CENTER OF SAINT AUGUSTINE, PA
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 11/03/2010
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Provider Practice Location Address
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Address Line | 301 HEALTH PARK BLVD STE 329
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32086-5771
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Country | US
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Telephone | 904-825-4333
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Fax | 904-825-4248
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Provider Business Mailing Address
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Address Line | 238 FIDDLERS POINT DR
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32080-6133
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Country | US
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Telephone | 904-825-4333
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Fax | 904-825-4248
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Authorized Official
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Title or Position | PHYSCIAN
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Name | DR. KRISHNA SIKARIA
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Credential | M.D.
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Telephone | 904-825-4333
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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 | ME0064435
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License Number State | FL
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