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General NPI Number Information
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NPI Number | 1497187538
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Entity Type | Organization
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Legal Business Name | ADVANCED CARDIOLOGY CONCEPTS
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Dates
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Enumeration Date | 07/31/2013
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 4980 W 10TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-3437
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Country | US
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Telephone | 305-822-0068
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Fax | 305-819-4445
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Provider Business Mailing Address
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Address Line | 4499 ALTON RD
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2852
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Country | US
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Telephone | 786-351-9697
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Fax | 305-819-4445
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Authorized Official
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Title or Position | CEO
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Name | MARIA JIMENA SALAS
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Credential | M.D.
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Telephone | 786-351-9697
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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 | ME 109984
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License Number State | FL
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