Organization Active NPI

Cardiology Associates of Polk County

  • Specialist
  • Lakeland, FL
National Provider Identifier
1861693616
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME87246 Issued in FL
Legal business name
CARDIOLOGY ASSOCIATES OF POLK COUNTY
Practice address
1417 Lakeland Hills Blvd
Suite 106
Lakeland, FL 33805-3200
Phone
(863) 682-8401
Fax
(863) 802-9611
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

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

Authorized official

Name
Susan Talit
Title
Office Manager
Phone
(863) 682-8401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME87246 FL Primary

Addresses

Primary practice location

1417 Lakeland Hills Blvd
Suite 106
Lakeland, FL 33805-3200

Mailing address

PO Box 93254
Lakeland, FL 33804-3254
Phone (863) 682-8401

Other identifiers 1

IdentifierTypeStateIssuer
062994400MedicaidFL

National Provider Directory

National Provider Directory

Locations

1417 Lakeland Hills Blvd
Ste 106
Lakeland, FL 33805
Phone (863) 682-8401

1305 Lakeland Hills Blvd
Ste 101
Lakeland, FL 33805
Phone (863) 682-8401

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238976000000",
    "number": "1861693616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93254",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338043254",
            "telephone_number": "863-682-8401",
            "fax_number": "863-802-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 LAKELAND HILLS BLVD",
            "address_2": "SUITE 106",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053200",
            "telephone_number": "863-682-8401",
            "fax_number": "863-802-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOLOGY ASSOCIATES OF POLK COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2009-04-06",
        "status": "A",
        "authorized_official_last_name": "TALIT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "863-682-8401"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME87246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062994400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.