Provider Demographics
NPI:1437967338
Name:ST. PANTALEON CARDIOLOGY LLC
Entity type:Organization
Organization Name:ST. PANTALEON CARDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-360-1118
Mailing Address - Street 1:2716 STONEWOOD PARK LOOP
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-6213
Mailing Address - Country:US
Mailing Address - Phone:813-360-1118
Mailing Address - Fax:
Practice Address - Street 1:2716 STONEWOOD PARK LOOP
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-6213
Practice Address - Country:US
Practice Address - Phone:813-360-1118
Practice Address - Fax:557-201-3626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2025-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty