Healthcare Provider Details

I. General information

NPI: 1619930450
Provider Name (Legal Business Name): SOUTH FLORIDA PULMONARY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5733 NW 151ST ST
MIAMI LAKES FL
33014-2481
US

IV. Provider business mailing address

5733 NW 151ST ST
MIAMI LAKES FL
33014-2481
US

V. Phone/Fax

Practice location:
  • Phone: 305-826-4172
  • Fax: 305-826-4178
Mailing address:
  • Phone: 305-826-4172
  • Fax: 305-826-4178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberHME # 701
License Number StateFL

VIII. Authorized Official

Name: MR. ERNESTO PADRON JR.
Title or Position: PRESIDENT
Credential: RESPIRATORY THERAPIS
Phone: 305-826-4172