# INTRACOASTAL CARDIOTHORACIC SURGERY, LLC

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

## Provider details

- **NPI number:** 1710994389
- **Authorized official:** WILLIAM H HEITMAN MD (MANAGING MEMBER)
- **Authorized official phone:** (561) 694-6911

## Contact information

- **Practice address:** 3370 BURNS RD, SUITE 102, PALM BEACH GARDENS, FL 33410-4327
- **Practice address phone:** (561) 694-6911
- **Practice address fax:** (561) 625-3239
- **Mailing address:** 3370 BURNS RD, SUITE 102, PALM BEACH GARDENS, FL 33410-4327
- **Mailing address phone:** (561) 694-6911
- **Mailing address fax:** (561) 625-3239

## 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:** 08/03/2006
- **Last updated:** 08/22/2020