1285021477 NPI number — FLORIDA INSTITUTE OF HEATL, LTD, LLLP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285021477 NPI number — FLORIDA INSTITUTE OF HEATL, LTD, LLLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLORIDA INSTITUTE OF HEATL, LTD, LLLP
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:
1285021477
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4850 W OAKLAND PARK BLVD
Provider Second Line Business Mailing Address:
SUITE 203
Provider Business Mailing Address City Name:
LAUDERDALE LAKES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33313-7260
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-484-7030
Provider Business Mailing Address Fax Number:
954-484-1280

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7421 NW 4TH ST
Provider Second Line Business Practice Location Address:
SUITE101
Provider Business Practice Location Address City Name:
PLANTATION
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33317-2204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-616-5593
Provider Business Practice Location Address Fax Number:
954-368-2562
Provider Enumeration Date:
04/25/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SETH
Authorized Official First Name:
RAGHAV
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CARDIOVASCULAR DISEASE, MD
Authorized Official Telephone Number:
954-616-5593

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  ME52141 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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