Provider Demographics
NPI:1619262870
Name:TREASURE COAST CARDIOVASCULAR INSTITUTE INC
Entity Type:Organization
Organization Name:TREASURE COAST CARDIOVASCULAR INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PETER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-766-0855
Mailing Address - Street 1:1285 36TH ST STE 200B
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6588
Mailing Address - Country:US
Mailing Address - Phone:772-999-3996
Mailing Address - Fax:866-506-8393
Practice Address - Street 1:1285 36TH ST STE 200B
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6588
Practice Address - Country:US
Practice Address - Phone:772-999-3996
Practice Address - Fax:866-506-8393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018168000Medicaid