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General NPI Number Information
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NPI Number | 1568472652
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Entity Type | Organization
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Legal Business Name | EAST PASCO PULMONARY & CRITICAL CARE ASSOCIATES INC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 38152 MEDICAL CENTER AVENUE
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City | ZEPHYRHILLS
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State | FL
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Zip | 33540
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Country | US
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Telephone | 813-782-4560
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Fax | 813-788-9202
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Provider Business Mailing Address
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Address Line | 38152 MEDICAL CENTER AVENUE
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City | ZEPHYRHILLS
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State | FL
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Zip | 33540
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Country | US
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Telephone | 813-782-4560
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Fax | 813-788-9202
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MARLENY CHAKOLA
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Credential |
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Telephone | 813-782-4560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME42585
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License Number State | FL
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