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General NPI Number Information
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NPI Number | 1801198023
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Entity Type | Organization
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Legal Business Name | WEST FLORIDA CARDIOLOGY NETWORK, LLC
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Dates
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Enumeration Date | 11/19/2010
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | 6006 49TH ST N SUITE 200
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City | SAINT PETERSBURG
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State | FL
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Zip | 33709-2148
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Country | US
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Telephone | 727-490-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 6006 49TH ST N SUITE 200
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City | SAINT PETERSBURG
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State | FL
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Zip | 33709-2148
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Country | US
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Telephone | 727-490-2100
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Fax |
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Authorized Official
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Title or Position | VP
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Name | JOHN JOHANNESSAN
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Credential |
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Telephone | 727-490-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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