Provider Demographics
NPI:1548434319
Name:SOUTH MIAMI CARDIOLOGY PA
Entity type:Organization
Organization Name:SOUTH MIAMI CARDIOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:MILAGROS
Authorized Official - Middle Name:
Authorized Official - Last Name:SERIANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-663-1001
Mailing Address - Street 1:7330 SW 62ND PL
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4825
Mailing Address - Country:US
Mailing Address - Phone:305-663-1001
Mailing Address - Fax:305-663-1007
Practice Address - Street 1:7330 SW 62ND PL
Practice Address - Street 2:SUITE 310
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4825
Practice Address - Country:US
Practice Address - Phone:305-663-1001
Practice Address - Fax:305-663-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1114989837Medicare PIN
FL1225090921Medicare PIN