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Organization

ADVANCED CARDIAC DIAGNOSTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL ANDREW ILLOVSKY MD (CHIEF EXECUTIVE OFFICER)
(904) 315-2004
Entity
Organization

Contact information

Practice address
2507 HOLLY POINT RD E, ORANGE PARK, FL 32073-5632
(904) 315-2004
Mailing address
PO BOX 814, ORANGE PARK, FL 32067-0814
(904) 315-2004

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME74432
FL

Other

Enumeration date
10/22/2011
Last updated
08/01/2013
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