Organization
INSTITUTE FOR ADVANCED THORACIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARID GHARAGOZLOO MD (OWNER)
(407) 747-1899
Entity
Organization
Contact information
Practice address
6718 LAKE NONA BLVD, ORLANDO, FL 32827-7982
(407) 747-1899
Mailing address
5092 ISLEWORTH COUNTRY CLUB DR, WINDERMERE, FL 34786-8920
(202) 841-7304
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
04/13/2022
Last updated
08/16/2022
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