Provider Demographics
NPI:1093195869
Name:HEART TO HEART PEDIATRIC CARDIOLOGY
Entity Type:Organization
Organization Name:HEART TO HEART PEDIATRIC CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-425-5614
Mailing Address - Street 1:1111 BALMORAL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3331
Mailing Address - Country:US
Mailing Address - Phone:502-425-5614
Mailing Address - Fax:502-425-5633
Practice Address - Street 1:3801 SPRINGHURST BLVD STE 104
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-6137
Practice Address - Country:US
Practice Address - Phone:502-425-5614
Practice Address - Fax:502-425-5633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty