Provider Demographics
NPI:1700118650
Name:CARDIOLOGY CENTER DIAGNOSTICS LLC
Entity type:Organization
Organization Name:CARDIOLOGY CENTER DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:GURTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-349-6350
Mailing Address - Street 1:1111 MEDICAL CENTER BLVD # S350
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3151
Mailing Address - Country:US
Mailing Address - Phone:504-349-6350
Mailing Address - Fax:504-349-6283
Practice Address - Street 1:1111 MEDICAL CENTER BLVD # S350
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3151
Practice Address - Country:US
Practice Address - Phone:504-349-6350
Practice Address - Fax:504-349-6283
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARDIOLOGY CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty