Provider Demographics
NPI:1689924219
Name:TAMPA CARDIOVASCULAR INSTITUTE
Entity Type:Organization
Organization Name:TAMPA CARDIOVASCULAR INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:NASUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-250-4178
Mailing Address - Street 1:3401 W WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2713
Mailing Address - Country:US
Mailing Address - Phone:813-932-6106
Mailing Address - Fax:800-307-8418
Practice Address - Street 1:3401 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2713
Practice Address - Country:US
Practice Address - Phone:813-932-6106
Practice Address - Fax:800-307-8418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113737207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty