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NPI Code Detail

MEDICARE: CARDIOLOGY CONSULTANTS,P.A.

MEDICARE: CARDIOLOGY CONSULTANTS,P.A.
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
12471N0900XNuclear Medicine Technology Radiologic Technologist3516-3FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
108208OTHERFLBLUE CROSS
299507OTHERFLBLUE CROSS GROUP
347318OTHERFLBLUE CROSS
448856OTHERFLBLUE CROSS
505909OTHERFLBLUE CROSS

General Provider Information

NPI Number : 1821241563
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARDIOLOGY CONSULTANTS,P.A.
Provider Business Mailing Address
First Line : 2320 N ORANGE AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32804-5506
Country : US
Telephone Number : 407-896-0054
Fax Number : 407-898-4463
Provider Business Practice Location Address
First Line : 2320 N ORANGE AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32804-5506
Country : US
Telephone Number : 407-896-0054
Fax Number : 407-898-4463
Authorized Official
Title or Position : CEO
Name : DR. JAMES BOLEN
Credential : M.D.
Telephone Number : 407-896-0054
Provider Enumeration Date : 10/28/2008
Last Update Date : 10/28/2008

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