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General NPI Number Information
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NPI Number | 1790305340
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Entity Type | Organization
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Legal Business Name | CORAL SPRINGS PULMONARY MEDICINE, P.A.
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Dates
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Enumeration Date | 04/23/2020
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 10752 HAWKS VISTA ST
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City | PLANTATION
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State | FL
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Zip | 33324-8212
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Country | US
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Telephone | 404-309-8591
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Fax |
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Provider Business Mailing Address
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Address Line | 2507 PROVENCE CIR
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City | WESTON
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State | FL
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Zip | 33327-1302
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Country | US
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Telephone | 404-309-8591
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BASHEER TASHTOUSH
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Credential | MD
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Telephone | 404-309-8591
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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 |
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License Number State |
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