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NPI Code Detail

MEDICARE: ADVANCED HEART GROUP P L

MEDICARE: ADVANCED HEART GROUP P L
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
1332B00000XDurable Medical Equipment & Medical SuppliesME 90030FL

General Provider Information

NPI Number : 1457679953
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED HEART GROUP P L
Provider Business Mailing Address
First Line : PO BOX 731138
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32173-1138
Country : US
Telephone Number : 386-675-6589
Fax Number : 386-675-6589
Provider Business Practice Location Address
First Line : 26 N BEACH ST
Second Line : SUITE C
City : ORMOND BEACH
State : FL
Zip : 32174-5663
Country : US
Telephone Number : 386-675-6589
Fax Number : 386-675-6589
Authorized Official
Title or Position : MANAGER
Name : DR. AHMAD SHAMSIN
Credential : MD
Telephone Number : 386-767-9585
Provider Enumeration Date : 05/07/2010
Last Update Date : 05/07/2010

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Directions to “ADVANCED HEART GROUP P L ” Practice Location

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