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FIRST COAST CARDIOVASCULAR INSTITUTE, LLC
NPI 1265973911
Internal Medicine - Cardiovascular Disease in Palatka, FL

Active since March 14, 2017CLIA Certified · 4 labs
205 ZEAGLER DR, PALATKA, FL 32177(904) 493-3333(904) 493-2222 Get Directions Write a Review

NPPES record last updated: April 24, 2023. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Mar 12, 2021, Mar 5, 2021, Mar 14, 2017 (3 updates tracked since 2017).

About First Coast Cardiovascular Institute, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FIRST COAST CARDIOVASCULAR INSTITUTE, LLC (NPI 1265973911) is a healthcare organization registered as a cardiovascular disease in Palatka, Florida and active in the NPI registry since March 2017. The organization holds 4 active CLIA laboratory certificates and lists Yazan Khatib, President, as its authorized official.

NPPES Registry Identity

NPI1265973911
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameFIRST COAST CARDIOVASCULAR INSTITUTE, LLC
Location Address205 ZEAGLER DRPalatka, FL 32177-3888
Mailing AddressPo Box 551308Jacksonville, FL 32255-1308 · (904) 493-3333 · Fax (904) 493-2222
Phone(904) 493-3333
Fax(904) 493-2222
Organization SubpartNo
Authorized OfficialYazan KhatibPresident · (904) 493-3333
Enumeration DateMarch 14, 2017
Last NPPES UpdateApril 24, 20233 updates tracked since enumeration
NPPES CertifiedApril 24, 2023
✔ NPI 1265973911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
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.
Also ListedInternal Medicine · Clinical Cardiac ElectrophysiologyTaxonomy 207RC0001X
Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X
Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X
Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X
Also ListedSurgeryTaxonomy 208600000X
205 ZEAGLER DR, Palatka, FL 32177
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 10D2121619

First Coast Cardiovascular Institute LLC · Palatka, FL
Active · expires Dec 26, 2026
CLIA Number10D2121619
Laboratory TypePhysician Office
Certificate Effective DateDecember 27, 2024
Certificate Expiration DateDecember 26, 2026
Laboratory DirectorYazan Khatib
Laboratory Phone(904) 589-0847
Laboratory LocationFirst Coast Cardiovascular Institute LLC205 Zeagler Dr, Palatka, FL 32177
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 10D2094861

First Coast Cardiovascular Institute, LLC · Fruit Cove, FL
Active · expires Apr 26, 2027
CLIA Number10D2094861
Laboratory TypePhysician Office
Certificate Effective DateApril 27, 2025
Certificate Expiration DateApril 26, 2027
Laboratory DirectorYazan Khatib
Laboratory Phone(904) 493-3333
Laboratory LocationFirst Coast Cardiovascular Institute, LLC115 Bartram Oaks Walk Suite 104, Fruit Cove, FL 32259
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2094470

First Coast Cardiovascular Institute, LLC · Jacksonville, FL
Active · expires Apr 16, 2027
CLIA Number10D2094470
Laboratory TypePhysician Office
Certificate Effective DateApril 17, 2025
Certificate Expiration DateApril 16, 2027
Laboratory DirectorYazan Khatib
Laboratory Phone(904) 493-3333
Laboratory LocationFirst Coast Cardiovascular Institute, LLC905 Beach Blvd, Jacksonville, FL 32250
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2094471

First Coast Cardiovascular Institute, LLC · Jacksonville, FL
Active · expires Apr 16, 2027
CLIA Number10D2094471
Laboratory TypePhysician Office
Certificate Effective DateApril 17, 2025
Certificate Expiration DateApril 16, 2027
Laboratory DirectorYazan Khatib
Laboratory Phone(904) 493-3333
Laboratory LocationFirst Coast Cardiovascular Institute, LLC3890 Dunn Ave Ste 203, Jacksonville, FL 32218
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIE CATHERINE GROUT MPT,ATC, LAT
Physical Therapist
205 ZEAGLER DR, SUITE 401
PALATKA, FL 32177
Putnam County (904) 755-8844
MR. MICHAEL ALLEN HICKS ARNP-C
Nurse Practitioner (Family)
205 ZEAGLER DR
PALATKA, FL 32177
Putnam County (386) 328-6746
DR. RICHARD A. PERALLON DMD
Dentist (General Practice)
205 ZEAGLER DR, SUITE 301
PALATKA, FL 32177
Putnam County (386) 325-4504
JEFFREY R. SLOTTEN
Clinic/Center (Dental)
205 ZEAGLER DR, SUITE 502
PALATKA, FL 32177
Putnam County (386) 328-1500
DR. ANTHONY J PACITTI M.D.
Surgery
205 ZEAGLER DR, SUITE 203
PALATKA, FL 32177
Putnam County (386) 312-8519
DR. JEFFREY REID SLOTTEN D.D.S.
Dentist (General Practice)
205 ZEAGLER DR, SUITE 502
PALATKA, FL 32177
Putnam County (386) 328-1500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is First Coast Cardiovascular Institute, LLC's NPI number?

The NPI number for First Coast Cardiovascular Institute, LLC is 1265973911. It was assigned to this organization in the NPPES registry on March 14, 2017.

Where is First Coast Cardiovascular Institute, LLC located?

First Coast Cardiovascular Institute, LLC is located at 205 Zeagler Dr, Palatka, FL 32177. The listed phone number is (904) 493-3333.

What is First Coast Cardiovascular Institute, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Does First Coast Cardiovascular Institute, LLC hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does First Coast Cardiovascular Institute, LLC accept?

Health plans from Medica list First Coast Cardiovascular Institute, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for First Coast Cardiovascular Institute, LLC was last updated on April 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.