Basic Information
| Provider Information | |||||||||
| NPI: | 1245244540 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRAL FLORIDA CARDIOLOGY GROUP PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1745 N MILLS AVE | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078417151 | ||||||||
| FaxNumber: | 4076482259 | ||||||||
| Practice Location | |||||||||
| Address1: | 1745 N MILLS AVE | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078417151 | ||||||||
| FaxNumber: | 4076482259 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2006 | ||||||||
| LastUpdateDate: | 03/05/2010 | ||||||||
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| AuthorizedOfficialLastName: | TAUSSIG | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4078417151 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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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.