Provider Demographics
NPI:1982988978
Name:ADVANCED CARE CARDIOLOGY, PA
Entity Type:Organization
Organization Name:ADVANCED CARE CARDIOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:W
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:386-672-8103
Mailing Address - Street 1:1400 HAND AVE STE R
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8196
Mailing Address - Country:US
Mailing Address - Phone:386-677-7875
Mailing Address - Fax:386-672-8102
Practice Address - Street 1:1400 HAND AVE STE R
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8196
Practice Address - Country:US
Practice Address - Phone:386-677-7875
Practice Address - Fax:386-672-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-08
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty