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General NPI Number Information
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NPI Number | 1306849773
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Entity Type | Organization
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Legal Business Name | MIAMI CARDIOPULMONARY INSTITUTE LLC
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 3200 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134-7239
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Country | US
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Telephone | 305-448-9990
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Fax | 305-448-9993
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Provider Business Mailing Address
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Address Line | 3200 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134-7239
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Country | US
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Telephone | 305-448-9990
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Fax | 305-448-9993
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Authorized Official
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Title or Position | PRESIDENT/MEDICAL DIRECTOR
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Name | DR. ILDEFONSO J MAS JR.
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Credential | M.D.
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Telephone | 305-448-9990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | N/A-OP CARDIAC CATH
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License Number State | FL
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