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NPI Code Detail

MEDICARE: CORAL REEF EKG ASSOCIATES INC

MEDICARE: CORAL REEF EKG ASSOCIATES INC
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
1174400000XSpecialistFL

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 : 1588791693
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORAL REEF EKG ASSOCIATES INC
Provider Business Mailing Address
First Line : 8353 SW 124TH ST
Second Line : SUITE #208
City : MIAMI
State : FL
Zip : 33156-5851
Country : US
Telephone Number : 305-235-9078
Fax Number : 305-235-8290
Provider Business Practice Location Address
First Line : 9333 SW 152ND ST
Second Line :
City : VILLAGE OF PALMETTO BAY
State : FL
Zip : 33157-1778
Country : US
Telephone Number : 305-251-2500
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : GINO VITIELLO
Credential : M.D.
Telephone Number : 305-255-2500
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/21/2022

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Directions to “CORAL REEF EKG ASSOCIATES INC ” Practice Location

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