Healthcare Provider Details

I. General information

NPI: 1336357086
Provider Name (Legal Business Name): PULMONARY & CRITICAL CARE CONSULTANTS OF SOUTH FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6134 HOLLYWOOD BLVD
HOLLYWOOD FL
33024
US

IV. Provider business mailing address

PO BOX 1193
HALLANDALE FL
33008-1193
US

V. Phone/Fax

Practice location:
  • Phone: 954-589-0974
  • Fax: 954-589-0975
Mailing address:
  • Phone: 954-589-0974
  • Fax: 954-589-0975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME80940
License Number StateFL

VIII. Authorized Official

Name: DR. KAMAL ANJUM
Title or Position: OWNER
Credential: MD
Phone: 305-332-9977