Organization
FLORIDA CARDIAC CONSULTANTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SPETSIOS (ADMINISTRATOR)
(941) 917-0060
Entity
Organization
Contact information
Practice address
463 CARLTON ST, WAUCHULA, FL 33873-3400
(863) 767-0660
Mailing address
PO BOX 25377, SARASOTA, FL 34277
(941) 917-0060
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057520800
—
FL
01
—
98788
BLUE CROSS/BLUE SHIELD
FL
01
—
CA6910
RAILROAD MEDICARE
FL
Enumeration date
07/11/2008
Last updated
07/11/2008
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