Provider Demographics
NPI:1821241563
Name:CARDIOLOGY CONSULTANTS,P.A.
Entity Type:Organization
Organization Name:CARDIOLOGY CONSULTANTS,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-896-0054
Mailing Address - Street 1:2320 N ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5506
Mailing Address - Country:US
Mailing Address - Phone:407-896-0054
Mailing Address - Fax:407-898-4463
Practice Address - Street 1:2320 N ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5506
Practice Address - Country:US
Practice Address - Phone:407-896-0054
Practice Address - Fax:407-898-4463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3516-32471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine TechnologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08208OtherBLUE CROSS
FL99507OtherBLUE CROSS GROUP
FL47318OtherBLUE CROSS
FL48856OtherBLUE CROSS
FL05909OtherBLUE CROSS
FLB27236Medicare UPIN
FLD55009Medicare UPIN
FL99507OtherBLUE CROSS GROUP
FLCG1924Medicare PIN
FL05909OtherBLUE CROSS