# INSTITUTE FOR ADVANCED THORACIC SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376285999
- **Authorized official:** FARID GHARAGOZLOO MD (OWNER)
- **Authorized official phone:** (407) 747-1899

## Contact information

- **Practice address:** 6718 LAKE NONA BLVD, ORLANDO, FL 32827-7982
- **Practice address phone:** (407) 747-1899
- **Mailing address:** 5092 ISLEWORTH COUNTRY CLUB DR, WINDERMERE, FL 34786-8920
- **Mailing address phone:** (202) 841-7304

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/13/2022
- **Last updated:** 08/16/2022