Provider Demographics
NPI:1821237892
Name:MIAMI CARDIOVASCULAR SERVICES LLC
Entity Type:Organization
Organization Name:MIAMI CARDIOVASCULAR SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ILDEFONSO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:MAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-497-2710
Mailing Address - Street 1:3181 CORAL WAY
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145
Mailing Address - Country:US
Mailing Address - Phone:786-497-2710
Mailing Address - Fax:
Practice Address - Street 1:3181 CORAL WAY
Practice Address - Street 2:6TH FLOOR
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-3216
Practice Address - Country:US
Practice Address - Phone:786-497-2710
Practice Address - Fax:786-497-2711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 49087207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME 49087OtherMEDICAL LICENSE NUMBER