Provider Demographics
NPI:1942254057
Name:MIRAMAR EKG READERS
Entity Type:Organization
Organization Name:MIRAMAR EKG READERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOV
Authorized Official - Middle Name:S
Authorized Official - Last Name:LINZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-450-2100
Mailing Address - Street 1:PO BOX 919008
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-9008
Mailing Address - Country:US
Mailing Address - Phone:954-726-1808
Mailing Address - Fax:954-726-1820
Practice Address - Street 1:1901 SW 172ND AVE
Practice Address - Street 2:EKG READERS PANEL
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5592
Practice Address - Country:US
Practice Address - Phone:954-726-1808
Practice Address - Fax:954-726-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
97528OtherBLUE CROSS/ BLUE SHIELD
SG078456OtherVISTA
SG078456OtherVISTA