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General NPI Number Information
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NPI Number | 1487153599
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Entity Type | Organization
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Legal Business Name | FLORIDA HEART LLC
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Dates
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Enumeration Date | 02/03/2018
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Last Update Date | 02/03/2018
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Provider Practice Location Address
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Address Line | 201 N PARK AVE STE 300
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City | APOPKA
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State | FL
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Zip | 32703-4147
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Country | US
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Telephone | 407-808-2150
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Fax |
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Provider Business Mailing Address
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Address Line | 12714 JACOB GRACE CT
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City | WINDERMERE
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State | FL
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Zip | 34786-5711
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | D.O./OWNER
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Name | DR. KHURRAM SHAHZAD
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Credential | M.D.
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Telephone | 407-808-2150
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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 | ME105659
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License Number State | FL
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