Provider Demographics
NPI:1992014708
Name:CARDIOLOGY SPECIALISTS OF FLORIDA PLLC
Entity Type:Organization
Organization Name:CARDIOLOGY SPECIALISTS OF FLORIDA PLLC
Other - Org Name:HERNANDO HEART CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:FENSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-597-3353
Mailing Address - Street 1:3069 ANDERSON SNOW RD
Mailing Address - Street 2:#219
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-5202
Mailing Address - Country:US
Mailing Address - Phone:352-597-3353
Mailing Address - Fax:352-597-3368
Practice Address - Street 1:14540 CORTEZ BLVD
Practice Address - Street 2:STE 119
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-6056
Practice Address - Country:US
Practice Address - Phone:352-597-3353
Practice Address - Fax:352-597-3368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-28
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty