=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790867810
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CINCINNATI HEART GROUP INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 625 EDEN PARK DRIVE SUITE 340
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-651-0222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 625 EDEN PARK DRIVE SUITE 340
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-651-0222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ROBERT J TOLTZIS
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 513-651-0222
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------