Provider Demographics
NPI:1417978743
Name:CARDIAC & VASCULAR SPECIALISTS OF MIAMI PA
Entity Type:Organization
Organization Name:CARDIAC & VASCULAR SPECIALISTS OF MIAMI PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-498-2151
Mailing Address - Street 1:680 2ND AVE N
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5753
Mailing Address - Country:US
Mailing Address - Phone:239-498-2151
Mailing Address - Fax:239-498-5280
Practice Address - Street 1:680 2ND AVE N
Practice Address - Street 2:SUITE 203
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5753
Practice Address - Country:US
Practice Address - Phone:239-498-2151
Practice Address - Fax:239-498-5280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID
FL=========OtherTAX ID