Provider Demographics
NPI:1134396872
Name:ADVANCED CARDIAC CARE INC
Entity type:Organization
Organization Name:ADVANCED CARDIAC CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:AL
Authorized Official - Last Name:KAMME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-249-3281
Mailing Address - Street 1:10945 DYLAN LOREN CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-4450
Mailing Address - Country:US
Mailing Address - Phone:407-249-3282
Mailing Address - Fax:407-249-3282
Practice Address - Street 1:10945 DYLAN LOREN CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4450
Practice Address - Country:US
Practice Address - Phone:407-249-3282
Practice Address - Fax:407-249-3282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88855207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN5625OtherRAIL ROAD MEDICARE
FLAL004Medicare PIN