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General NPI Number Information
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NPI Number | 1922447143
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Entity Type | Organization
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Legal Business Name | PREMIER CARDIOLOGY ASSOCIATES, LLC
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 07/28/2020
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Provider Practice Location Address
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Address Line | 661 GOODLETTE-FRANK RD N STE 104
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City | NAPLES
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State | FL
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Zip | 34102-5609
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Country | US
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Telephone | 239-674-6593
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Fax | 941-827-2932
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Provider Business Mailing Address
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Address Line | 661 GOODLETTE-FRANK RD N STE 104
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City | NAPLES
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State | FL
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Zip | 34102-5609
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Country | US
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Telephone | 239-674-6593
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Fax | 941-827-2932
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Authorized Official
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Title or Position | CEO, PRESIDENT, DIRECTOR
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Name | RICHARD DEMAIO
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Credential |
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Telephone | 917-969-1925
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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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