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General NPI Number Information
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NPI Number | 1578884391
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Entity Type | Organization
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Legal Business Name | ATLANTIC CARDIOVASCULAR CONSULTANTS PLLC
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Dates
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Enumeration Date | 06/15/2010
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 2650 N MILITARY TRL STE 140
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City | BOCA RATON
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State | FL
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Zip | 33431-6346
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Country | US
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Telephone | 561-450-8750
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Fax | 561-450-6731
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Provider Business Mailing Address
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Address Line | 2650 N MILITARY TRL STE 140
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City | BOCA RATON
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State | FL
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Zip | 33431-6346
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Country | US
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Telephone | 561-450-8750
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Fax | 561-450-6731
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. JOHN A DISILVESTRO
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Credential | MD
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Telephone | 561-450-8750
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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 | ME95626
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License Number State | FL
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