Healthcare Provider Details

I. General information

NPI: 1669382404
Provider Name (Legal Business Name): PULMONARY CLINICAL SOLUTIONS LOUISIANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4405 AIRLINE DR
BOSSIER CITY LA
71111-2058
US

IV. Provider business mailing address

701 N FEDERAL HWY STE 501
HALLANDALE BEACH FL
33009-2467
US

V. Phone/Fax

Practice location:
  • Phone: 318-747-5440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ERIC JARQUIN
Title or Position: FINANCIAL CONTROLLER
Credential:
Phone: 954-651-8332