Provider Demographics
NPI:1790998698
Name:MAYORGA CARDIOLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:MAYORGA CARDIOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYORGA-CORTES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-412-7225
Mailing Address - Street 1:9195 SUNSET DR.
Mailing Address - Street 2:SUITE230
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173
Mailing Address - Country:US
Mailing Address - Phone:305-412-7225
Mailing Address - Fax:305-412-7229
Practice Address - Street 1:9195 SW 72ND ST
Practice Address - Street 2:SUITE230
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3488
Practice Address - Country:US
Practice Address - Phone:305-412-7225
Practice Address - Fax:305-412-7229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME22452207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL92157Medicare ID - Type Unspecified