Provider Demographics
NPI:1801198023
Name:WEST FLORIDA CARDIOLOGY NETWORK, LLC
Entity Type:Organization
Organization Name:WEST FLORIDA CARDIOLOGY NETWORK, LLC
Other - Org Name:THE HEART INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHANNESSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-490-2100
Mailing Address - Street 1:6006 49TH ST N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2148
Mailing Address - Country:US
Mailing Address - Phone:727-490-2100
Mailing Address - Fax:
Practice Address - Street 1:6006 49TH ST N
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2148
Practice Address - Country:US
Practice Address - Phone:727-490-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-19
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty