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General NPI Number Information
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NPI Number | 1902605660
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Entity Type | Organization
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Legal Business Name | ATLANTIC COAST CARDIOLOGY LLC
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 8245 BAYBERRY RD
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7432
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Country | US
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Telephone | 904-296-7775
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Fax | 904-296-7760
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Provider Business Mailing Address
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Address Line | 8245 BAYBERRY RD
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7432
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Country | US
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Telephone | 904-296-7775
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Fax | 904-296-7760
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Authorized Official
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Title or Position | MD /OWNER
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Name | DR. ABDUL R KANI
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Credential | MD
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Telephone | 904-296-7775
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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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