Organization
INDIAN RIVER HEALTH SERVICES INC
Active
Other names
Cardiac Surgery Group
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY L SUSI (CEO)
(772) 567-4311
Entity
Organization
Contact information
Practice address
1040 37TH PL, SUITE 101, VERO BEACH, FL 32960-4806
(772) 563-4580
(772) 563-4690
Mailing address
1000 36TH ST, VERO BEACH, FL 32960-4862
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275383904
—
FL
01
—
39813D
BLUE CROSS
FL
Enumeration date
08/21/2006
Last updated
01/10/2019
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