Provider Demographics
NPI:1003907296
Name:CVT SURGICAL SPECIALISTS
Entity Type:Organization
Organization Name:CVT SURGICAL SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:A.
Authorized Official - Middle Name:HADI
Authorized Official - Last Name:HAKKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-394-8100
Mailing Address - Street 1:10333 SEMINOLE BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-4204
Mailing Address - Country:US
Mailing Address - Phone:727-394-8100
Mailing Address - Fax:727-394-8906
Practice Address - Street 1:10333 SEMINOLE BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-4210
Practice Address - Country:US
Practice Address - Phone:727-394-8100
Practice Address - Fax:727-394-8906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0048511208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL065177000Medicaid
FLE17813Medicare UPIN
FL02089AMedicare PIN