Healthcare Provider Details
I. General information
NPI: 1528643293
Provider Name (Legal Business Name): FLORIDA CHEST CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/15/2021
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
370 34TH ST S
ST PETERSBURG FL
33711-1328
US
IV. Provider business mailing address
370 34TH ST S
ST PETERSBURG FL
33711-1328
US
V. Phone/Fax
- Phone: 727-353-3530
- Fax: 727-353-3313
- Phone: 727-353-3530
- Fax: 727-353-3313
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RANA
KANAAN
Title or Position: OWNER
Credential: MD
Phone: 727-347-5242