Provider Demographics
NPI:1215041603
Name:CARDIO OPTIONS INC.
Entity Type:Organization
Organization Name:CARDIO OPTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:LEEMOND
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-268-6679
Mailing Address - Street 1:12627 SAN JOSE BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-2662
Mailing Address - Country:US
Mailing Address - Phone:904-268-6679
Mailing Address - Fax:904-425-3236
Practice Address - Street 1:12627 SAN JOSE BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-2662
Practice Address - Country:US
Practice Address - Phone:904-268-6679
Practice Address - Fax:904-425-3236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259067OtherAVMED PROVIDER NUMBER
FLE9114Medicare ID - Type UnspecifiedPROVIDER NUMBER