Healthcare Provider Details

I. General information

NPI: 1649385725
Provider Name (Legal Business Name): HEART & LUNG ASSOCIATES P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 10/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7420 NW 5TH ST SUITE 103
PLANTATION FL
33317-1611
US

IV. Provider business mailing address

7420 NW 5TH ST SUITE 103
PLANTATION FL
33317-1611
US

V. Phone/Fax

Practice location:
  • Phone: 954-474-4704
  • Fax: 954-474-0114
Mailing address:
  • Phone: 954-474-4704
  • Fax: 954-474-0114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME71844
License Number StateFL

VIII. Authorized Official

Name: SUNIL KUMAR
Title or Position: PRESIDENT
Credential: MD
Phone: 954-474-4704