MEDICARE: TAMPA BAY RESPIRATORY SERVICES CORP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RP1001X	Pulmonary Disease Physician
2	2278P1004X	Pulmonary Diagnostics Certified Respiratory Therapist
3	2279P1004X	Pulmonary Diagnostics Registered Respiratory Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RT14832	OTHER	FL	RRT
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295493914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMPA BAY RESPIRATORY SERVICES CORP

Provider Business Mailing Address
First Line	:	13911 N DALE MABRY HWY STE 108
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2414
Country	:	US
Telephone Number	:	813-964-6395
Fax Number	:	813-964-6551

Provider Business Practice Location Address
First Line	:	13911 N DALE MABRY HWY STE 108
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2414
Country	:	US
Telephone Number	:	813-964-6395
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YOANA FERNANDEZ
Credential	:	RRT
Telephone Number	:	813-964-6395

Provider Enumeration Date	:	11/30/2021
Last Update Date	:	12/02/2022

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Directions to “TAMPA BAY RESPIRATORY SERVICES CORP ” Practice Location

Language	Start Address	Practice Location

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