Provider Demographics
NPI:1790291912
Name:HOPKINS CARDIOVASCULAR ASSOCIATES LLC
Entity Type:Organization
Organization Name:HOPKINS CARDIOVASCULAR ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-355-5336
Mailing Address - Street 1:2401 UNIVERSITY PKWY STE 204A
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2973
Mailing Address - Country:US
Mailing Address - Phone:941-355-5336
Mailing Address - Fax:941-761-6000
Practice Address - Street 1:2401 UNIVERSITY PKWY STE 204A
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2973
Practice Address - Country:US
Practice Address - Phone:941-355-5336
Practice Address - Fax:941-761-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-26
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL96050207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004104100Medicaid