First Coast Cardiovascular Institute, LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

FIRST COAST CARDIOVASCULAR INSTITUTE, LLC

Practice address

115 Bartram Oaks Walk Ste 104
Fruit Cove, FL 32259-3247

Phone

(904) 493-3333

Fax

(904) 268-5505

NPI assigned

Mar 14, 2017

Last updated

Jan 7, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Yazan Khatib, MDNPI 1588653257

Title

President

Phone

(904) 493-3333

Specialties & licenses 7

Addresses

Tax ID family

First Coast Cardiovascular Institute LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• First Coast Cardiovascular Institute LLC

  • Cardiac Rehabilitation Clinic/Center
  • Jacksonville, FL
  • NPI 1013711498
  NPD tax ID
• First Coast Cardiovascular Institute, LLC

  • Cardiovascular Disease Physician
  • Jacksonville, FL
  • NPI 1083155725
  NPD tax ID
• First Coast Cardiovascular Institute, LLC

  • Cardiovascular Disease Physician
  • Fleming Island, FL
  • NPI 1255872982
  NPD tax ID
• First Coast Cardiovascular Institute, LLC

  • Cardiovascular Disease Physician
  • Palatka, FL
  • NPI 1265973911
  NPD tax ID
• First Coast Cardiovascular Institute, LLC

  • Cardiovascular Disease Physician
  • Jacksonville, FL
  • NPI 1811438559
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yazan Khatib, MD

  • Interventional Cardiology Physician
  • Jacksonville, FL
  • NPI 1588653257
  Authorized official Same address or phone

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1659812394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551308",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322551308",
            "telephone_number": "904-493-3333",
            "fax_number": "904-493-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BARTRAM OAKS WALK STE 104",
            "city": "FRUIT COVE",
            "state": "FL",
            "postal_code": "322593247",
            "telephone_number": "904-493-3333",
            "fax_number": "904-268-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST CARDIOVASCULAR INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-14",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "KHATIB",
        "authorized_official_first_name": "YAZAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-493-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Fruit Cove, FL
• Providers in Fruit Cove, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.