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Organization

FIRST COAST CARDIOVASCULAR INSTITUTE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. YAZAN KHATIB MD (PRESIDENT)
(904) 493-3333
Entity
Organization

Contact information

Practice address
7011 A C SKINNER PKWY, SUITE 160, JACKSONVILLE, FL 32256-6954
(904) 493-3333
(904) 493-2222
Mailing address
PO BOX 551308, JACKSONVILLE, FL 32255-1308
(904) 493-3333
(904) 493-2222

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
FL
207RC0001X
Clinical Cardiac Electrophysiology Physician
FL
207RI0011X
Interventional Cardiology Physician
FL
207RN0300X
Nephrology Physician
FL
207RP1001X
Pulmonary Disease Physician
FL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
207UN0901X
Nuclear Cardiology Physician
FL
2084N0400X
Neurology Physician
FL
2084N0600X
Clinical Neurophysiology Physician
FL
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
FL
208600000X
Surgery Physician
208M00000X
Hospitalist Physician
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
117885400
FL
01
34459
BCBS
Enumeration date
08/24/2006
Last updated
01/07/2025
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