Provider Demographics
NPI:1578933115
Name:GULF COAST CARDIOTHORACIC SURGERY INSTITUTE, INC
Entity Type:Organization
Organization Name:GULF COAST CARDIOTHORACIC SURGERY INSTITUTE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ERHARD
Authorized Official - Suffix:
Authorized Official - Credentials:CMPE
Authorized Official - Phone:707-363-7627
Mailing Address - Street 1:17 DAVIS BLVD
Mailing Address - Street 2:313
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3475
Mailing Address - Country:US
Mailing Address - Phone:813-906-1400
Mailing Address - Fax:813-354-2321
Practice Address - Street 1:101 W BEACH PL
Practice Address - Street 2:1800
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2334
Practice Address - Country:US
Practice Address - Phone:813-906-1400
Practice Address - Fax:813-354-2321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty