Provider Demographics
NPI:1659642288
Name:CARDIOLOGY ASSOCIATES OF CENTRAL BREVARD LLC
Entity Type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF CENTRAL BREVARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-243-4936
Mailing Address - Street 1:3571 S ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-2111
Mailing Address - Country:US
Mailing Address - Phone:321-243-4936
Mailing Address - Fax:
Practice Address - Street 1:3571 S ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-2111
Practice Address - Country:US
Practice Address - Phone:321-243-4936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty