Basic Information
| Provider Information | |||||||||
| NPI: | 1144651373 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARDIAC VISION LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 1ST ST S | ||||||||
| Address2: | SUITE 1204 | ||||||||
| City: | JACKSONVILLE BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322506443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3128639630 | ||||||||
| FaxNumber: | 9044933395 | ||||||||
| Practice Location | |||||||||
| Address1: | 7807 BAYMEADOWS RD E | ||||||||
| Address2: | SUITE 209 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322569664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042301204 | ||||||||
| FaxNumber: | 9042301207 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2013 | ||||||||
| LastUpdateDate: | 12/13/2013 | ||||||||
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| AuthorizedOfficialLastName: | AHMED | ||||||||
| AuthorizedOfficialFirstName: | JUNAID | ||||||||
| AuthorizedOfficialMiddleName: | ABDUL | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3128639630 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.