Organization
CARDIOVASCULAR PREVENTATIVE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL NORBERG MD (MANAGER)
(954) 425-6200
Entity
Organization
Contact information
Practice address
1 SW 129TH AVE, SUITE 105, PEMBROKE PINES, FL 33027-1761
(954) 425-6200
(941) 460-4097
Mailing address
1 SW 129TH AVE, SUITE 105, PEMBROKE PINES, FL 33027-1761
(954) 425-6200
(941) 460-4097
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME64325
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014065300
—
FL
01
—
HCC10249
AHCA LICENSE
FL
01
—
IC289A
MEDICARE PTAN
FL
Enumeration date
09/08/2014
Last updated
06/09/2015
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