Provider Demographics
NPI:1821349531
Name:ACRC-CARDIOLOGY
Entity Type:Organization
Organization Name:ACRC-CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-964-7880
Mailing Address - Street 1:8188 S JOG RD
Mailing Address - Street 2:STE 204
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-2952
Mailing Address - Country:US
Mailing Address - Phone:561-964-7880
Mailing Address - Fax:561-964-7877
Practice Address - Street 1:5503 S CONGRESS AVE
Practice Address - Street 2:STE 102
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6625
Practice Address - Country:US
Practice Address - Phone:561-966-8815
Practice Address - Fax:561-966-4905
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC CLINICAL RESEARCH COLLABORATIVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch