FIRST COAST CARDIOVASCULAR INSTITUTE PA NPI 1841307857

NPI Information

NPI: 1841307857
Provider Name: FIRST COAST CARDIOVASCULAR INSTITUTE PA
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

CLIA Number: 10D2249103

Address:
7011 A C SKINNER PKWY
SUITE 160
JACKSONVILLE, FL
ZIP 32256
Phone: (904) 493-3333
Get Directions

FIRST COAST CARDIOVASCULAR INSTITUTE PA is a cardiovascular disease internal medicine in Jacksonville, 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. FIRST COAST CARDIOVASCULAR INSTITUTE PA NPI is 1841307857. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7011 A C SKINNER PKWY
SUITE 160
JACKSONVILLE, FL
ZIP 32256-954
Phone: (904) 493-3333
Fax: (904) 493-2222

The provider's authorized official is Yazan Khatib .
The authorized official title is President and has the following contact phone number (904) 493-3333.

The CLIA number assigned to this NPI record is 10D2249103 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/24/2006 and was last updated on 3/12/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	207RC0001X	Internal Medicine	Clinical Cardiac Electrophysiology	FLORIDA	No
2	207RI0011X	Internal Medicine	Interventional Cardiology	FLORIDA	No
3	207RN0300X	Internal Medicine	Nephrology	FLORIDA	No
4	207RP1001X	Internal Medicine	Pulmonary Disease	FLORIDA	No
5	207RS0012X	Internal Medicine	Sleep Medicine		No
6	207UN0901X	Nuclear Medicine	Nuclear Cardiology	FLORIDA	No
7	2084N0400X	Psychiatry & Neurology	Neurology	FLORIDA	No
8	2084N0600X	Psychiatry & Neurology	Clinical Neurophysiology	FLORIDA	No
9	2084S0012X	Psychiatry & Neurology	Sleep Medicine	FLORIDA	No
10	208600000X	Surgery			No
11	208M00000X	Hospitalist		FLORIDA	No
12	207RC0000X	Internal Medicine	Cardiovascular Disease	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	34459	OTHER		BCBS
2	265739206	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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