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General NPI Number Information
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NPI Number | 1316182850
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Entity Type | Organization
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Legal Business Name | FLORIDA HEART GROUP
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 12/12/2008
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Provider Practice Location Address
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Address Line | 601 E ROLLINS AVE
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City | ORLANDO
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State | FL
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Zip | 32803-1248
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Country | US
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Telephone | 407-422-9831
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Fax | 407-648-2065
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Provider Business Mailing Address
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Address Line | PO BOX 144333
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City | ORLANDO
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State | FL
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Zip | 32814-4333
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Country | US
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Telephone | 407-422-9831
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Fax | 407-648-2065
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. JOAN BRYAN
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Credential |
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Telephone | 407-894-4474
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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 |
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