Provider Demographics
NPI:1104026467
Name:FLORIDA CARDIOLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:FLORIDA CARDIOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SUDHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:AGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-848-6400
Mailing Address - Street 1:2410 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2236
Mailing Address - Country:US
Mailing Address - Phone:727-848-6400
Mailing Address - Fax:727-848-6200
Practice Address - Street 1:3543 LITTLE RD STE A
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1814
Practice Address - Country:US
Practice Address - Phone:727-848-6400
Practice Address - Fax:727-848-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003208400Medicaid
FL251732OtherWELLCARE
DN7755OtherRAILROAD MEDICARE
FL98688OtherBCBS OF FL
DN7755OtherRAILROAD MEDICARE