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General NPI Number Information
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NPI Number | 1437197530
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Entity Type | Organization
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Legal Business Name | FLORIDA INSTITUTE FOR CARDIOVASCULAR CARE PA
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 3702 WASHINGTON ST SUITE 305
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8282
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Country | US
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Telephone | 954-967-6550
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Fax | 954-967-6553
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Provider Business Mailing Address
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Address Line | 3241 EXECUTIVE WAY
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City | MIRAMAR
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State | FL
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Zip | 33025-3931
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Country | US
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Telephone | 954-967-6550
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Fax | 954-962-3914
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN POLNER
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Credential | M.D.
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Telephone | 954-430-3866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #2
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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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