MEDICARE: SOUTH FLORIDA CARDIOTHORACIC AND VASCULAR SURGERY PL

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician

General Provider Information

NPI Number	:	1851450712
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH FLORIDA CARDIOTHORACIC AND VASCULAR SURGERY PL

Provider Business Mailing Address
First Line	:	PO BOX 816759
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33081-0759
Country	:	US
Telephone Number	:	954-963-0234
Fax Number	:	954-963-0237

Provider Business Practice Location Address
First Line	:	3850 HOLLYWOOD BLVD
Second Line	:	SUITE 302
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6748
Country	:	US
Telephone Number	:	954-963-0234
Fax Number	:	954-963-0237

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD CARTLEDGE
Credential	:	M.D.
Telephone Number	:	954-963-0234

Provider Enumeration Date	:	12/07/2006
Last Update Date	:	08/22/2020

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