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General NPI Number Information
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NPI Number | 1881686459
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Entity Type | Organization
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Legal Business Name | PASCO CARDIOLOGY CENTER INC
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 08/15/2018
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Provider Practice Location Address
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Address Line | 14153 YOSEMITE DR STE 202
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City | HUDSON
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State | FL
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Zip | 34667
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Country | US
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Telephone | 727-868-5404
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Fax | 727-863-1787
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Provider Business Mailing Address
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Address Line | 14153 YOSEMITE DR STE 202
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City | HUDSON
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State | FL
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Zip | 34667-6575
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Country | US
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Telephone | 727-868-5404
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Fax | 727-863-1787
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Authorized Official
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Title or Position | PRESIDENT
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Name | FONG MEI CHANG
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Credential | MD
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Telephone | 727-868-5404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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