Organization
CARDIOSOM, LLC
Active
Other names
CardioSom of Palm Beach Gardens
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY JARRELL (PRESIDENT/COO)
(317) 706-1080
Entity
Organization
Contact information
Practice address
3385 BURNS RD, SUITE 105, PALM BEACH GARDENS, FL 33410-4328
(561) 804-7636
(561) 804-7501
Mailing address
615 W. CARMEL DR., SUITE 100, CARMEL, IN 46032-5504
(317) 706-1080
(317) 574-8674
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
1312686
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1312686
FLORIDA AHCA LICENSE
FL
Enumeration date
11/10/2005
Last updated
08/10/2010
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