Provider Demographics
NPI:1245311612
Name:FLORIDA ADVANCED CARDIOTHORACIC INSTITUTE, PL
Entity type:Organization
Organization Name:FLORIDA ADVANCED CARDIOTHORACIC INSTITUTE, PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-844-8155
Mailing Address - Street 1:5 TAMPA GENERAL CIR
Mailing Address - Street 2:SUITE 820
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3601
Mailing Address - Country:US
Mailing Address - Phone:813-844-8155
Mailing Address - Fax:813-844-7730
Practice Address - Street 1:5 TAMPA GENERAL CIR
Practice Address - Street 2:SUITE 820
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3601
Practice Address - Country:US
Practice Address - Phone:813-844-8155
Practice Address - Fax:813-844-7730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ0438Medicare PIN