Provider Demographics
NPI:1710047626
Name:GENE E MYERS CARDIAC AND VASCULAR CONSULTANTS, PA
Entity Type:Organization
Organization Name:GENE E MYERS CARDIAC AND VASCULAR CONSULTANTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-365-6611
Mailing Address - Street 1:2540 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-4501
Mailing Address - Country:US
Mailing Address - Phone:941-365-6611
Mailing Address - Fax:941-366-2684
Practice Address - Street 1:2540 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-4501
Practice Address - Country:US
Practice Address - Phone:941-365-6611
Practice Address - Fax:941-366-2684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21467Medicare PIN
FLD56095Medicare UPIN
FLA51476Medicare UPIN
FLG50433Medicare UPIN
FLE37669Medicare UPIN