Provider Demographics
NPI:1457319329
Name:CARDIAC CLINIC OF SUNIL M. KAKKAR, M.D, P.A
Entity Type:Organization
Organization Name:CARDIAC CLINIC OF SUNIL M. KAKKAR, M.D, P.A
Other - Org Name:CARDIAC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAKKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-933-1423
Mailing Address - Street 1:311 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4421
Mailing Address - Country:US
Mailing Address - Phone:407-933-1423
Mailing Address - Fax:407-933-7901
Practice Address - Street 1:311 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4421
Practice Address - Country:US
Practice Address - Phone:407-933-1423
Practice Address - Fax:407-933-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL49046YMedicare ID - Type UnspecifiedSUNIL M. KAKKAR, M.D
FL49046WMedicare PIN
FL97822Medicare PIN
FL04460XMedicare PIN
FLD55563Medicare UPIN
FL23959XMedicare PIN
FLG45902Medicare UPIN
FL38087YMedicare PIN
FLE85386Medicare UPIN
FL23959YMedicare ID - Type UnspecifiedPADMA K. RAJU, M.D
FLD51020Medicare UPIN
FL04460ZMedicare ID - Type UnspecifiedDIANNE S ZULLOW, M.D
FLG37096Medicare PIN
FLH55151Medicare UPIN
FL38087ZMedicare ID - Type UnspecifiedATUL MADAN, M.D