Provider Demographics
NPI:1912257791
Name:ANGELZHEART
Entity Type:Organization
Organization Name:ANGELZHEART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SONOGRAPHER, PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PUBIEN
Authorized Official - Suffix:
Authorized Official - Credentials:RDCS
Authorized Official - Phone:786-547-1000
Mailing Address - Street 1:1485 NE 121ST ST
Mailing Address - Street 2:#D507
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-6534
Mailing Address - Country:US
Mailing Address - Phone:786-547-1000
Mailing Address - Fax:
Practice Address - Street 1:1485 NE 121ST ST
Practice Address - Street 2:#D507
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-6534
Practice Address - Country:US
Practice Address - Phone:786-547-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty