1649565177 NPI number — METABOLIC AND CARDIOVASCULAR INSTITUTE OF FLORIDA

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 1649565177 NPI number — METABOLIC AND CARDIOVASCULAR INSTITUTE OF FLORIDA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METABOLIC AND CARDIOVASCULAR INSTITUTE OF FLORIDA
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:
6
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:
1649565177
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2651
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33480-2651
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-833-8663
Provider Business Mailing Address Fax Number:
561-833-8663

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
340 COLUMBIA DR
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
WEST PALM BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33409-1975
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-395-6731
Provider Business Practice Location Address Fax Number:
561-616-0222
Provider Enumeration Date:
06/13/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SADOW
Authorized Official First Name:
SAMUEL
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
772-233-8183

Provider Taxonomy Codes

  • Taxonomy code: 1744R1102X , with the licence number:  ME45344 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RB0002X , with the licence number: ME45344 , 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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