Basic Information
| Provider Information | |||||||||
| NPI: | 1811940802 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARDIOLOGY CONSULTANTS | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HEART & VASCULAR INSTITUTE OF FLORIDA - SOUTH PINELLAS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 560 JACKSON ST N | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337051405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273291600 | ||||||||
| FaxNumber: | 7273291694 | ||||||||
| Practice Location | |||||||||
| Address1: | 560 JACKSON ST N | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337051405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273291600 | ||||||||
| FaxNumber: | 7273291694 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 02/02/2010 | ||||||||
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| AuthorizedOfficialLastName: | BORSCHEL | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7273291610 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 274152100 | 05 | FL | MEDICAID |