Organization
CHILDREN'S HEART SPECIALISTS, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN VILLAFANE M.D. (PRESIDENT)
(502) 584-3200
Entity
Organization
Contact information
Practice address
731 E BROADWAY, LOUISVILLE, KY 40202-1711
(502) 584-3200
(502) 584-3333
Mailing address
743 E. BROADWAY, #300, LOUISVILLE, KY 40202
(502) 584-3200
(502) 584-3333
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
24893
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100020940
—
IN
01
—
1052899
PASSPORT
KY
05
—
64248933
—
KY
Enumeration date
02/15/2007
Last updated
06/11/2014
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