Provider Demographics
NPI:1003969437
Name:LAKEWOOD CARDIOVASCULAR CONSULTANTS P A
Entity Type:Organization
Organization Name:LAKEWOOD CARDIOVASCULAR CONSULTANTS P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:E
Authorized Official - Last Name:CALDERON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-907-1113
Mailing Address - Street 1:6310 HEALTH PARK WAY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5177
Mailing Address - Country:US
Mailing Address - Phone:941-907-1113
Mailing Address - Fax:941-907-3887
Practice Address - Street 1:6310 HEALTH PARK WAY
Practice Address - Street 2:SUITE 230
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-5177
Practice Address - Country:US
Practice Address - Phone:941-907-1113
Practice Address - Fax:941-907-3887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77684207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty