Healthcare Provider Details

I. General information

NPI: 1942730577
Provider Name (Legal Business Name): BREATHE DIAGNOSTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 HOLIDAY SPRINGS BLVD APT 8
MARGATE FL
33063-5459
US

IV. Provider business mailing address

3155 HOLIDAY SPRINGS BLVD SUITE 8
MARGATE FL
33063
US

V. Phone/Fax

Practice location:
  • Phone: 954-653-8599
  • Fax: 954-688-2508
Mailing address:
  • Phone: 954-653-8599
  • Fax: 954-688-2508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberTT0008704
License Number StateFL

VIII. Authorized Official

Name: MR. ANDREW SAMUELS
Title or Position: PRESIDENT
Credential: CERT RESPIRATORY
Phone: 954-653-8599