MEDICARE: CLEARWATER CARDIOVASCULAR AND INTERVENTIONAL CONSULTANTS MD PA

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RC0001X	Clinical Cardiac Electrophysiology Physician
2	208600000X	Surgery Physician
3	207UN0901X	Nuclear Cardiology Physician
4	207RS0012X	Sleep Medicine (Internal Medicine) Physician
5	2084N0400X	Neurology Physician
6	2084N0600X	Clinical Neurophysiology Physician
7	208M00000X	Hospitalist Physician
8	207RP1001X	Pulmonary Disease Physician
9	207RN0300X	Nephrology Physician
10	207RI0011X	Interventional Cardiology Physician
11	163WC3500X	Cardiac Rehabilitation Registered Nurse
12	207RC0000X	Cardiovascular Disease Physician

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

NPI Number	:	1659396133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEARWATER CARDIOVASCULAR AND INTERVENTIONAL CONSULTANTS MD PA

Provider Business Mailing Address
First Line	:	455 PINELLAS ST STE 400
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3356
Country	:	US
Telephone Number	:	727-445-1992
Fax Number	:	727-445-1993

Provider Business Practice Location Address
First Line	:	455 PINELLAS STREET
Second Line	:	SUITE 400
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3356
Country	:	US
Telephone Number	:	727-445-1911
Fax Number	:	727-445-1986

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. KEVIN B MAIR
Credential	:
Telephone Number	:	727-445-1992

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	03/03/2026