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General NPI Number Information
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NPI Number | 1639362429
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Entity Type | Organization
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Legal Business Name | LARGO CARDIOLOGY LLC
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 08/24/2007
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Provider Practice Location Address
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Address Line | THREE MARYLAND FARMS SUITE 250
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City | BRENTWOOD
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State | TN
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Zip | 37027
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Country | US
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Telephone | 615-372-5024
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Fax | 866-899-5924
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Provider Business Mailing Address
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Address Line | 2401 WEST BAY DRIVE SUITE 503
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City | LARGO
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State | FL
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Zip | 33770
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Country | US
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Telephone | 727-585-0900
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Fax | 727-585-0950
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. JOHN JOHANNESSEN
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Credential |
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Telephone | 727-793-6004
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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 |
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License Number State |
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