Provider Demographics
NPI:1497187538
Name:ADVANCED CARDIOLOGY CONCEPTS
Entity Type:Organization
Organization Name:ADVANCED CARDIOLOGY CONCEPTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:JIMENA
Authorized Official - Last Name:SALAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-351-9697
Mailing Address - Street 1:4499 ALTON RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2852
Mailing Address - Country:US
Mailing Address - Phone:786-351-9697
Mailing Address - Fax:305-819-4445
Practice Address - Street 1:4980 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3437
Practice Address - Country:US
Practice Address - Phone:305-822-0068
Practice Address - Fax:305-819-4445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-31
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 109984207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty