=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184946139
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PEDIATRIC RESPIRATORY CARE OF SOUTH FLORIDA, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2010
-----------------------------------------------------
Last Update Date | 05/22/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4101 SW 73RD AVE UNIT C
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33155-4520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-248-1003
-----------------------------------------------------
Fax | 305-248-1009
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4101 SW 73RD AVE UNIT C
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33155-4520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-248-1003
-----------------------------------------------------
Fax | 305-248-1009
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP
-----------------------------------------------------
Name | KAREN S ALBA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-248-1003
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 227900000X
-----------------------------------------------------
Taxonomy Name | Registered Respiratory Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2279C0205X
-----------------------------------------------------
Taxonomy Name | Critical Care Registered Respiratory Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2279H0200X
-----------------------------------------------------
Taxonomy Name | Home Health Registered Respiratory Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 2279E1000X
-----------------------------------------------------
Taxonomy Name | Educational Registered Respiratory Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 2279P1004X
-----------------------------------------------------
Taxonomy Name | Pulmonary Diagnostics Registered Respiratory Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 2279P1005X
-----------------------------------------------------
Taxonomy Name | Pulmonary Rehabilitation Registered Respiratory Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
Taxonomy Code | 2279P1006X
-----------------------------------------------------
Taxonomy Name | Pulmonary Function Technologist Registered Respiratory Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #8
-----------------------------------------------------
Taxonomy Code | 2279P3900X
-----------------------------------------------------
Taxonomy Name | Neonatal/Pediatric Registered Respiratory Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #9
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number | 1313932-DBPR326951
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #10
-----------------------------------------------------
Taxonomy Code | 2279G1100X
-----------------------------------------------------
Taxonomy Name | General Care Registered Respiratory Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------