NPIMap

Organization Active NPI

Lake Worth Cardiology Consultants LLC

  • Specialist
  • Greenacres, FL
National Provider Identifier
1386896173
Registry record updated Mar 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME102740 Issued in FL
Legal business name
LAKE WORTH CARDIOLOGY CONSULTANTS LLC
Practice address
4849 Lake Worth Rd
Greenacres, FL 33463-3455
Phone
(561) 433-4446
Fax
(561) 433-3026
NPI assigned
Oct 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Adeline Etienne
Title
Manager
Phone
(718) 972-9712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME102740 FL Primary

Addresses

Primary practice location

4849 Lake Worth Rd
Greenacres, FL 33463-3455

Mailing address

4849 Lake Worth Rd
Greenacres, FL 33463-3455
Phone (561) 202-6064

Other identifiers 1

IdentifierTypeStateIssuer
1336161603OtherFLNATIONAL PROVIDER ID

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238198400000",
    "number": "1386896173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 LAKE WORTH RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633455",
            "telephone_number": "561-202-6064",
            "fax_number": "561-202-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 LAKE WORTH RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633455",
            "telephone_number": "561-433-4446",
            "fax_number": "561-433-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WORTH CARDIOLOGY CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-13",
        "last_updated": "2009-03-28",
        "status": "A",
        "authorized_official_last_name": "ETIENNE",
        "authorized_official_first_name": "ADELINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-972-9712",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME102740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER ID",
            "identifier": "1336161603",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.