Organization
FLORIDA CARDIOVASCULAR INSTITUTE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN THOMPSON SULLEBARGER M.D. (PRESIDENT)
(813) 353-1515
Entity
Organization
Contact information
Practice address
509 S ARMENIA AVE, STE. 200, TAMPA, FL 33609-3395
(813) 353-1515
(813) 353-0485
Mailing address
509 S ARMENIA AVE, STE. 200, TAMPA, FL 33609-3395
(813) 353-1515
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21968
BLUE CROSS BLUE SHIELD
FL
05
—
255769000
—
FL
Enumeration date
07/16/2006
Last updated
11/14/2008
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