MEDICARE: PEDIATRIC RESPIRATORY CARE OF SOUTH FLORIDA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	227900000X	Registered Respiratory Therapist
2	2279C0205X	Critical Care Registered Respiratory Therapist
3	2279H0200X	Home Health Registered Respiratory Therapist
4	2279E1000X	Educational Registered Respiratory Therapist
5	2279P1004X	Pulmonary Diagnostics Registered Respiratory Therapist
6	2279P1005X	Pulmonary Rehabilitation Registered Respiratory Therapist
7	2279P1006X	Pulmonary Function Technologist Registered Respiratory Therapist
8	2279P3900X	Neonatal/Pediatric Registered Respiratory Therapist
9	332BX2000X	Oxygen Equipment & Supplies (DME)	1313932-DBPR326951	FL
10	2279G1100X	General Care Registered Respiratory Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184946139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC RESPIRATORY CARE OF SOUTH FLORIDA, INC.

Provider Business Mailing Address
First Line	:	4101 SW 73RD AVE UNIT C
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4520
Country	:	US
Telephone Number	:	305-248-1003
Fax Number	:	305-248-1009

Provider Business Practice Location Address
First Line	:	4101 SW 73RD AVE UNIT C
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4520
Country	:	US
Telephone Number	:	305-248-1003
Fax Number	:	305-248-1009

Authorized Official
Title or Position	:	VP
Name	:	KAREN S ALBA
Credential	:
Telephone Number	:	305-248-1003

Provider Enumeration Date	:	02/18/2010
Last Update Date	:	05/22/2024

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Directions to “PEDIATRIC RESPIRATORY CARE OF SOUTH FLORIDA, INC. ” Practice Location

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