Provider Demographics
NPI:1184614851
Name:ALDRICH CARDIOVASCULAR INSTITUTE
Entity type:Organization
Organization Name:ALDRICH CARDIOVASCULAR INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:ALDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-359-8900
Mailing Address - Street 1:6310 HEALTH PARK WAY
Mailing Address - Street 2:SUITE 330
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202
Mailing Address - Country:US
Mailing Address - Phone:941-359-8900
Mailing Address - Fax:941-359-8991
Practice Address - Street 1:6310 HEALTH PARK WAY
Practice Address - Street 2:SUITE 330
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202
Practice Address - Country:US
Practice Address - Phone:941-359-8900
Practice Address - Fax:941-359-8991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8030Medicare PIN