Provider Demographics
NPI:1609126366
Name:FLORIDA KEYS CARDIOLOGY, LLC
Entity Type:Organization
Organization Name:FLORIDA KEYS CARDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MADHAVI
Authorized Official - Middle Name:GUNDA
Authorized Official - Last Name:CHUNDURU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-942-1550
Mailing Address - Street 1:P.O. BOX 9507
Mailing Address - Street 2:
Mailing Address - City:TAVERNIER
Mailing Address - State:FL
Mailing Address - Zip Code:33070-9507
Mailing Address - Country:US
Mailing Address - Phone:305-853-7171
Mailing Address - Fax:305-853-7151
Practice Address - Street 1:103400 OVERSEAS HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037
Practice Address - Country:US
Practice Address - Phone:305-853-7171
Practice Address - Fax:305-853-7151
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA KEYS CARDIOLOGY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-10
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86926207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty