Healthcare Provider Details

I. General information

NPI: 1093571127
Provider Name (Legal Business Name): MEDICAL PULMONARY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 N UNIVERSITY DR STE 107
CORAL SPRINGS FL
33065-5047
US

IV. Provider business mailing address

6610 N UNIVERSITY DR STE 120
TAMARAC FL
33321-4000
US

V. Phone/Fax

Practice location:
  • Phone: 954-340-1992
  • Fax: 954-340-1430
Mailing address:
  • Phone: 954-340-1992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS WEINER
Title or Position: PRESIDENT
Credential: MD
Phone: 954-340-1992