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NPI Code Detail

MEDICARE: ADVANCED CARDIOVASCULAR CONSULTANTS LLC

MEDICARE: ADVANCED CARDIOVASCULAR CONSULTANTS LLC
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
1207RC0000XCardiovascular Disease Physician

Other Identifiers

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

General Provider Information

NPI Number : 1306329370
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED CARDIOVASCULAR CONSULTANTS LLC
Provider Business Mailing Address
First Line : 5305 GREENWOOD AVE STE 204
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33407-2449
Country : US
Telephone Number : 561-882-6060
Fax Number : 561-845-2297
Provider Business Practice Location Address
First Line : 5305 GREENWOOD AVE STE 204
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33407-2449
Country : US
Telephone Number : 561-882-6060
Fax Number : 561-845-2297
Authorized Official
Title or Position : MEDICAL DOCTOR
Name : JYOTI MOHANTY
Credential : MD
Telephone Number : 561-313-7743
Provider Enumeration Date : 09/14/2018
Last Update Date : 09/29/2021

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Directions to “ADVANCED CARDIOVASCULAR CONSULTANTS LLC ” Practice Location

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