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General NPI Number Information
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NPI Number | 1750040994
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Entity Type | Organization
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Legal Business Name | SYDNOR CARDIOVASCULAR CENTER LLC
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Dates
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Enumeration Date | 12/15/2021
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 7111 1ST AVE S
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City | ST PETERSBURG
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State | FL
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Zip | 33707-1223
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Country | US
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Telephone | 727-300-2282
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Fax | 727-321-2680
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Provider Business Mailing Address
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Address Line | 25941 US HIGHWAY 19 N UNIT 14808
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City | CLEARWATER
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State | FL
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Zip | 33766-7025
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Country | US
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Telephone | 727-300-2282
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Fax | 727-321-2680
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Authorized Official
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Title or Position | OWNER
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Name | LILIAN AHIABLE
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Credential | MD
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Telephone | 727-300-2282
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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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