PINNACLE CARDIOVASCULAR ASSOCIATES INC (CARLOS ANTONIO LECHE MD) - NPI NUMBER 1356766513

Summary

Provider Name: PINNACLE CARDIOVASCULAR ASSOCIATES INC (CARLOS ANTONIO LECHE MD)

NPI Number: 1356766513

Clasification: Internal Medicine (207RC0000X)

Specialization: Cardiovascular Disease

Address:
1601 W REYNOLDS ST
SUITE 102
PLANT CITY, FL
ZIP 33563

Phone Number: (813) 326-4433



Detailed Information

PINNACLE CARDIOVASCULAR ASSOCIATES INC is a cardiovascular disease internist in Plant City, FL. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. The assigned NPI number for this provider is 1356766513 and is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Carlos Antonio Leche Md.

The provider's business address is:

1601 W REYNOLDS ST
SUITE 102
PLANT CITY, FL
ZIP 33563-748
Phone: (813) 326-4433

The provider's authorized official is Carlos A Leche .
The authorized official title is Owner and has the following contact phone number (813) 326-4433.

The enumeration date for this NPI number is 2/25/2014 and was last updated on 9/10/2014.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207RC0000X Internal Medicine Cardiovascular Disease ME93159 FL Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 U5686Z MEDICARE PIN FL
2 H55588 MEDICARE UPIN FL
3 008652800 MEDICAID FL

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1356766513 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name PINNACLE CARDIOVASCULAR ASSOCIATES INC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name CARLOS ANTONIO LECHE MD Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 3 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 1601 W REYNOLDS ST The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Second Line Business Practice Location Address SUITE 102 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Business Practice Location Address City Name PLANT CITY The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name FL The State code in the location of the provider being identified.
11 Provider Business Practice Location Address Postal Code 335634748 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
13 Provider Business Practice Location Address Telephone Number 8133264433 The telephone number associated with the location address of the provider being identified.
14 Provider Enumeration Date 2/25/2014 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 9/10/2014 The date that a record was last updated or changed.
16 Authorized Official Last Name LECHE The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
17 Authorized Official First Name CARLOS The first name of the authorized official.
18 Authorized Official Middle Name A The middle name of the authorized official.
19 Authorized Official Title or Position OWNER The title or position of the authorized official.
20 Authorized Official Telephone Number 8133264433 The 10-position telephone number of the authorized official.
21 Healthcare Provider Taxonomy Code 1 207RC0000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
22 Provider License Number 1 ME93159 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
23 Provider License Number State Code 1 FL The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
24 Healthcare Provider Primary Taxonomy Switch 1 Y
25 Other Provider Identifier 1 U5686Z Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
26 Other Provider Identifier Type Code 1 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier State 1 FL
28 Other Provider Identifier 2 H55588 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
29 Other Provider Identifier Type Code 2 02 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
30 Other Provider Identifier State 2 FL
31 Other Provider Identifier 3 008652800 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
32 Other Provider Identifier Type Code 3 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
33 Other Provider Identifier State 3 FL
34 Is Organization Subpart N
35 Authorized Official Name Prefix Text DR.
36 Authorized Official Credential Text MD
37 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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