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General NPI Number Information
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NPI Number | 1447926027
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Entity Type | Organization
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Legal Business Name | CLEARWATER CARDIOVASCULAR AND INTERVENTIONAL CONSULTANTS MD PA
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 8839 BRYAN DAIRY RD STE 300
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City | LARGO
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State | FL
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Zip | 33777-1207
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Country | US
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Telephone | 727-394-1911
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Fax | 727-394-1986
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Provider Business Mailing Address
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Address Line | 455 PINELLAS ST STE 400
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City | CLEARWATER
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State | FL
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Zip | 33756-3356
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Country | US
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Telephone | 727-445-1992
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. KEVIN B MAIR
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Credential |
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Telephone | 727-445-1992
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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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