Provider Demographics
NPI:1437114642
Name:HEART INSTITUTE OF VENICE PLLC
Entity Type:Organization
Organization Name:HEART INSTITUTE OF VENICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZAID
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-724-8960
Mailing Address - Street 1:1370 EAST VENICE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-9082
Mailing Address - Country:US
Mailing Address - Phone:941-412-0026
Mailing Address - Fax:941-412-0027
Practice Address - Street 1:1370 EAST VENICE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-9082
Practice Address - Country:US
Practice Address - Phone:941-412-0026
Practice Address - Fax:941-412-0027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94996OtherBCBS
FLDD8693OtherMCR RR
FL274068100Medicaid
FLDD8693OtherMCR RR
FL274068100Medicaid