Provider Demographics
NPI:1003026915
Name:ELITE CARDIOVASCULAR SURGEONS OF SOUTH FLORIDA
Entity Type:Organization
Organization Name:ELITE CARDIOVASCULAR SURGEONS OF SOUTH FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:UNGARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-771-8495
Mailing Address - Street 1:1880 E COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3747
Mailing Address - Country:US
Mailing Address - Phone:954-771-8495
Mailing Address - Fax:
Practice Address - Street 1:1880 E COMMERCIAL BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3747
Practice Address - Country:US
Practice Address - Phone:954-771-8495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME31942208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4851OtherMEDICARE
FLK4851OtherMEDICARE