Provider Demographics
NPI:1457786295
Name:INSTITUTE FOR ADVANCED CARDIOVASCULAR CARE, LLC
Entity Type:Organization
Organization Name:INSTITUTE FOR ADVANCED CARDIOVASCULAR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVAID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-572-8900
Mailing Address - Street 1:1136 CYPRESS GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7559
Mailing Address - Country:US
Mailing Address - Phone:407-572-8900
Mailing Address - Fax:
Practice Address - Street 1:3225 HILLSDALE LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7561
Practice Address - Country:US
Practice Address - Phone:407-572-8900
Practice Address - Fax:407-203-7733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 98873207RC0000X
207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty