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NPI Code Detail

MEDICARE: KEYS CARDIOLOGY PA

MEDICARE: KEYS CARDIOLOGY PA
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 PhysicianOS4428FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
182480OTHERFLBLUE CROSS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386740033
Entity Type Code : Organization
Provider Name (Legal Business Name) : KEYS CARDIOLOGY PA
Provider Business Mailing Address
First Line : PO BOX 220
Second Line :
City : LEHIGH ACRES
State : FL
Zip : 33970-0220
Country : US
Telephone Number : 239-369-4088
Fax Number : 239-369-0588
Provider Business Practice Location Address
First Line : 391 LEE BLVD
Second Line : SUITE 300
City : LEHIGH ACRES
State : FL
Zip : 33936-4973
Country : US
Telephone Number : 239-369-4088
Fax Number : 239-369-0588
Authorized Official
Title or Position : OWNER/PRESIDENT
Name : WILLIAM W RICHARDSON
Credential : DO
Telephone Number : 239-369-4088
Provider Enumeration Date : 09/16/2006
Last Update Date : 01/28/2015

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Directions to “KEYS CARDIOLOGY PA ” Practice Location

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