Organization
MIAMI CARDIOPULMONARY INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILDEFONSO J MAS JR. M.D. (PRESIDENT/MEDICAL DIRECTOR)
(305) 448-9990
Entity
Organization
Contact information
Practice address
3200 PONCE DE LEON BLVD, CORAL GABLES, FL 33134-7239
(305) 448-9990
(305) 448-9993
Mailing address
3200 PONCE DE LEON BLVD, CORAL GABLES, FL 33134-7239
(305) 448-9990
(305) 448-9993
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
N/A-OP CARDIAC CATH
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268091200
—
FL
01
—
291498
AVMED
FL
01
—
3321067
AETNA HMO
FL
01
—
3556558
AETNA
FL
01
—
45678
NEIGHBORHOOD HEALTH PLAN
FL
01
—
7388537
AETNA NON-HMO
FL
01
—
V2751
BLUE CROSS BLUE SHIELD
FL
01
—
V3352
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/31/2005
Last updated
06/20/2018
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