Organization
INTRACOASTAL CARDIAC SERVICES GEN PTRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J ANESTA MD (PRESIDENT)
(561) 278-3323
Entity
Organization
Contact information
Practice address
900 NW 17TH AVE, DELRAY BEACH, FL 33445-2519
(561) 278-3323
(561) 274-3963
Mailing address
150 S PINE ISLAND RD STE 390, PLANTATION, FL 33324-2667
(954) 726-1808
(954) 726-1820
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062451900
—
FL
01
—
72193
BCBS
FL
01
—
CI9848
RAILROAD MEDICARE
FL
Enumeration date
08/01/2006
Last updated
10/27/2023
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