| Organization Name: | PEDIATRIC CARDIOLOGY SERVICES LLC |
| NPI Number: | 1003077876 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIM WOODY (PRACTICE ADMINISTRATOR) |
| Mailing Address: | 200 S Enota Dr Ne Suite 380 Gainesville |
| State: | GA US |
| Postal Code: | 305013473 |
| Phone Number: | 7709956684 |
| Fax Number: | 7709957631 |
| NPI Enumeration Date: | 06/24/2008 |
| NPI Last Update Date: | 06/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080P0202X |
| License Number: | 043298 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Pediatric Cardiology |
| Taxonomy Definition: | A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |