Organization
FLORIDA HEART GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOAN BRYAN (ADMINISTRATOR)
(407) 894-4474
Entity
Organization
Contact information
Practice address
1613 N MILLS AVE, ORLANDO, FL 32803-1849
(407) 894-4474
(407) 894-7136
Mailing address
1613 N MILLS AVE, ORLANDO, FL 32803-1849
(407) 894-4474
(407) 894-7136
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME0016884
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5019744
AETNA
FL
01
—
99800
BCBS
FL
01
—
CI0696
RRR
FL
Enumeration date
06/28/2005
Last updated
12/14/2009
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