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.





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
1 NPI 1356766513
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name PINNACLE CARDIOVASCULAR ASSOCIATES INC
5 Provider Other Organization Name CARLOS ANTONIO LECHE MD
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 1601 W REYNOLDS ST
8 Provider Second Line Business Practice Location Address SUITE 102
9 Provider Business Practice Location Address City Name PLANT CITY
10 Provider Business Practice Location Address State Name FL
11 Provider Business Practice Location Address Postal Code 335634748
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 8133264433
14 Provider Enumeration Date 2/25/2014
15 Last Update Date 9/10/2014
16 Authorized Official Last Name LECHE
17 Authorized Official First Name CARLOS
18 Authorized Official Middle Name A
19 Authorized Official Title or Position OWNER
20 Authorized Official Telephone Number 8133264433
21 Healthcare Provider Taxonomy Code 1 207RC0000X
22 Provider License Number 1 ME93159
23 Provider License Number State Code 1 FL
24 Healthcare Provider Primary Taxonomy Switch 1 Y
25 Other Provider Identifier 1 U5686Z
26 Other Provider Identifier Type Code 1 08
27 Other Provider Identifier State 1 FL
28 Other Provider Identifier 2 H55588
29 Other Provider Identifier Type Code 2 02
30 Other Provider Identifier State 2 FL
31 Other Provider Identifier 3 008652800
32 Other Provider Identifier Type Code 3 05
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: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.