Provider Demographics
NPI:1134319957
Name:FLORIDA CARDIOVASCULAR SURGEONS INC
Entity Type:Organization
Organization Name:FLORIDA CARDIOVASCULAR SURGEONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-442-4178
Mailing Address - Street 1:1000 LAKEVIEW RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3475
Mailing Address - Country:US
Mailing Address - Phone:813-890-8004
Mailing Address - Fax:813-890-8114
Practice Address - Street 1:1000 LAKEVIEW RD
Practice Address - Street 2:SUITE 3
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3475
Practice Address - Country:US
Practice Address - Phone:813-890-8004
Practice Address - Fax:813-890-8114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME21236208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCM1677OtherPALMETTO GBA