Provider Demographics
NPI:1942495254
Name:SUNSET CARDIOLOGY LLC
Entity Type:Organization
Organization Name:SUNSET CARDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WIRGES
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:305-595-5558
Mailing Address - Street 1:9193 SUNSET DR
Mailing Address - Street 2:#210
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173
Mailing Address - Country:US
Mailing Address - Phone:305-595-5558
Mailing Address - Fax:305-595-4121
Practice Address - Street 1:9193 SUNSET DR
Practice Address - Street 2:#210
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173
Practice Address - Country:US
Practice Address - Phone:305-595-5558
Practice Address - Fax:305-595-4121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL378973000Medicaid