Provider Demographics
NPI:1508229972
Name:FLORIDA CARDIAC THERAPEUTICS, INC
Entity Type:Organization
Organization Name:FLORIDA CARDIAC THERAPEUTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-917-4751
Mailing Address - Street 1:301 W PLATT ST # 79
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2292
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10033 DOCTOR M.L.K. JR ST N
Practice Address - Street 2:SUITE 302
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716
Practice Address - Country:US
Practice Address - Phone:727-498-8898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty