National Provider Identifier Database

LEWIS KLANCKE CARDIOLOGY PA
Cardiovascular Disease

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.


Contact Information

LEWIS & KLANCKE CARDIOLOGY PA
695 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL32114
Phone: 386-258-8722
Fax: 386-258-9443
Website:
Specialty Taxonomy Code
* Cardiovascular Disease 207RC0000X
Clinical Cardiac Electrophysiology 207RC0001X
Interventional Cardiology 207RI0011X
Nuclear Cardiology 207UN0901X
Nurse Practitioner 363L00000X
Vascular Surgery 2086S0129X

* Indicates primary specialty

NPI Profile & details for LEWIS & KLANCKE CARDIOLOGY PA

NPI Number 1669589263
Legal business name
LBN
LEWIS & KLANCKE CARDIOLOGY PA
Authorized official KATHY PHILLIPS - (CREDENTIALING COORDINATOR)
Entity Organization
Organization subpart No
Enumeration date 08/23/2006
Last updated 09/13/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • FL Medicaid: 378998500
  • FL Other: 99279 BC/BS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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