Organization
BRADENTON CARDIOLOGY PHYSICIAN NETWORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN JOHANNESSEN (PRESIDENT)
(727) 793-6004
Entity
Organization
Contact information
Practice address
2010 59TH ST W, STE. 4200, BRADENTON, FL 34209-4616
(941) 794-3999
(941) 792-4048
Mailing address
2010 59TH ST W, STE. 4200, BRADENTON, FL 34209-4616
(941) 794-3999
(941) 792-4048
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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