Healthcare Provider Details
I. General information
NPI: 1013009810
Provider Name (Legal Business Name): PULMONARY & INTERNAL MEDICINE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/29/2006
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2221 SE OCEAN BLVD SUITE 100
STUART FL
34996-3341
US
IV. Provider business mailing address
2221 SE OCEAN BLVD SUITE 100
STUART FL
34996-3341
US
V. Phone/Fax
- Phone: 772-283-4428
- Fax:
- Phone: 772-283-4428
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
EDWIN
SWEET
Title or Position: PRESIDENT
Credential: M.D.
Phone: 772-283-4428