MEDICARE: HEART CARE OF SOUTHERN ARIZONA, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RS0012X	Sleep Medicine (Internal Medicine) Physician	0898214-5	AZ
2	207RP1001X	Pulmonary Disease Physician	0898214-5	AZ
3	207RC0001X	Clinical Cardiac Electrophysiology Physician	0898214-5	AZ
4	207UN0901X	Nuclear Cardiology Physician	0868214-5	AZ
5	363A00000X	Physician Assistant	0898214-5	AZ
6	207RC0000X	Cardiovascular Disease Physician	0898214-5	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235132838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART CARE OF SOUTHERN ARIZONA, PC

Provider Business Mailing Address
First Line	:	6080 N LA CHOLLA BLVD # 200
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-3533
Country	:	US
Telephone Number	:	520-797-8550
Fax Number	:	520-797-6986

Provider Business Practice Location Address
First Line	:	6080 N LA CHOLLA BLVD # 200
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-3533
Country	:	US
Telephone Number	:	520-797-8550
Fax Number	:	520-797-6986

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TEDD GOLDFINGER
Credential	:	DO
Telephone Number	:	520-797-8550

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	01/30/2008

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