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General NPI Number Information
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NPI Number | 1255466090
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Entity Type | Organization
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Legal Business Name | CARDIAC INSTITUTE OF THE PALM BEACHES PA
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 06/23/2010
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Provider Practice Location Address
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Address Line | 3355 BURNS RD STE 201
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4353
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Country | US
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Telephone | 561-296-5225
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Fax | 561-296-5226
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Provider Business Mailing Address
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Address Line | 3355 BURNS RD STE 201
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4353
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Country | US
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Telephone | 561-296-5225
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Fax | 561-296-5226
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. JEFFREY SCOTT FENSTER
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Credential | M.D., F.A.C.C.
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Telephone | 561-296-5225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | ME78204
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License Number State | FL
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