Provider Demographics
NPI:1811225295
Name:SOUTH FLORIDA CARDIOLOGY CONSULTANTS PA
Entity type:Organization
Organization Name:SOUTH FLORIDA CARDIOLOGY CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAYVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMINI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-499-9515
Mailing Address - Street 1:601 N. FLAMINGO RD.
Mailing Address - Street 2:SUITE 403
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1011
Mailing Address - Country:US
Mailing Address - Phone:954-499-9515
Mailing Address - Fax:954-499-7877
Practice Address - Street 1:601 N FLAMINGO RD
Practice Address - Street 2:SUITE 403
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1015
Practice Address - Country:US
Practice Address - Phone:954-499-9515
Practice Address - Fax:954-499-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDR0872OtherMEDICARE RAILROAD
FL279226500Medicaid
FL279226500Medicaid