Healthcare Provider Details

I. General information

NPI: 1679250476
Provider Name (Legal Business Name): CARDIOPULMONARY DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 FRUITLAND DR
DELTONA FL
32725-4594
US

IV. Provider business mailing address

1720 FRUITLAND DR
DELTONA FL
32725-4594
US

V. Phone/Fax

Practice location:
  • Phone: 407-970-9424
  • Fax:
Mailing address:
  • Phone: 407-970-9424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225B00000X
TaxonomyPulmonary Function Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2278E1000X
TaxonomyEducational Certified Respiratory Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2278G1100X
TaxonomyGeneral Care Certified Respiratory Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2278P1004X
TaxonomyPulmonary Diagnostics Certified Respiratory Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2278P1006X
TaxonomyPulmonary Function Technologist Certified Respiratory Therapist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code2279E1000X
TaxonomyEducational Registered Respiratory Therapist
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number
License Number State
# 9
Primary TaxonomyY
Taxonomy Code2279P1004X
TaxonomyPulmonary Diagnostics Registered Respiratory Therapist
License Number
License Number State
# 10
Primary TaxonomyN
Taxonomy Code2279P1006X
TaxonomyPulmonary Function Technologist Registered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: CARLOS MEJIA
Title or Position: OWNER
Credential: RRT
Phone: 407-970-9424