Provider Demographics
NPI:1720192750
Name:AVENTURA INSTITUTE FOR CARDIOVASCULAR WELLNESS PA
Entity Type:Organization
Organization Name:AVENTURA INSTITUTE FOR CARDIOVASCULAR WELLNESS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ACKERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-935-5101
Mailing Address - Street 1:2900 CORPORATE WAY STE D
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5603
Mailing Address - Fax:954-985-7073
Practice Address - Street 1:21097 NE 27TH CT STE 204
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1237
Practice Address - Country:US
Practice Address - Phone:954-265-7900
Practice Address - Fax:954-265-0266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7303207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDG6505OtherRAILROAD MEDICARE
FLQ0616Medicare PIN