Organization
PANEL OF EKG - LAKEWOOD
Active
Organization
PANEL OF EKG - LAKEWOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARINA COSTOPOULOS (ADMINISTRATOR)
(941) 365-8532
Entity
Organization
Contact information
Practice address
8340 LAKEWOOD RANCH BLVD, BRADENTON, FL 34202-5180
(941) 365-8532
Mailing address
PO BOX 25548, SARASOTA, FL 34277-2548
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
05/11/2006
Last updated
08/22/2020
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