1245257005 NPI number — CARDIOLOGY AND INTERNAL MEDICINE GROUP OF NORTH FLORIDA P A

Table of content: ANDREA LOU DROUIN LPCC (NPI 1003311077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245257005 NPI number — CARDIOLOGY AND INTERNAL MEDICINE GROUP OF NORTH FLORIDA P A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDIOLOGY AND INTERNAL MEDICINE GROUP OF NORTH FLORIDA P A
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245257005
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/05/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7100 HOLLYWOOD BLVD
Provider Second Line Business Mailing Address:
SUITE 23
Provider Business Mailing Address City Name:
PEMBROKE PINES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33024-7355
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-967-0107
Provider Business Mailing Address Fax Number:
850-653-4135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
155 AVENUE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APALACHICOLA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32320-2069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-653-4134
Provider Business Practice Location Address Fax Number:
850-653-4135
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NITSIOS
Authorized Official First Name:
HELEN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
850-653-4134

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 002311700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com