Healthcare Provider Details

I. General information

NPI: 1710229588
Provider Name (Legal Business Name): PEDIATRIC PULMONARY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13155 W DIXIE HWY
NORTH MIAMI FL
33161-4130
US

IV. Provider business mailing address

13155 WEST DIXIE HYGHWAY
NORTH MIAMI FL
33161-4130
US

V. Phone/Fax

Practice location:
  • Phone: 786-288-0617
  • Fax:
Mailing address:
  • Phone: 786-288-0617
  • Fax: 305-947-9823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. ROMUALD DANGERVIL
Title or Position: DIRECTOR
Credential:
Phone: 786-417-3957