Provider Demographics
NPI:1255437745
Name:CARDIOLOGY CONSULTANTS OF SOUTHWEST FLORIDA, INC.
Entity type:Organization
Organization Name:CARDIOLOGY CONSULTANTS OF SOUTHWEST FLORIDA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-415-4900
Mailing Address - Street 1:13411 PARKER COMMONS BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-1811
Mailing Address - Country:US
Mailing Address - Phone:239-415-4900
Mailing Address - Fax:
Practice Address - Street 1:13411 PARKER COMMONS BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-1811
Practice Address - Country:US
Practice Address - Phone:239-415-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74817OtherBLUE CROSS GROUP
FLK6047Medicare ID - Type UnspecifiedGROUP NUMBER