MEDICARE: HEART CENTER OF ACADIANA

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	207RC0000X	Cardiovascular Disease Physician	12136R	LA

General Provider Information

NPI Number	:	1548300866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART CENTER OF ACADIANA

Provider Business Mailing Address
First Line	:	PO BOX 53628
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70505-3628
Country	:	US
Telephone Number	:	337-291-9410
Fax Number	:	337-593-8310

Provider Business Practice Location Address
First Line	:	4906 AMBASSADOR CAFFERY PKWY
Second Line	:	N SUITE 1400
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-6965
Country	:	US
Telephone Number	:	337-988-9003
Fax Number	:	337-988-9921

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. SYED FAZAL-UR-REHMAN
Credential	:	M.D.,
Telephone Number	:	337-291-9410

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	10/30/2012

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Directions to “HEART CENTER OF ACADIANA ” Practice Location

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