Provider Demographics
NPI:1053649293
Name:PRECISION CARDIO PULMONARY, LLC
Entity Type:Organization
Organization Name:PRECISION CARDIO PULMONARY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:866-961-5589
Mailing Address - Street 1:2194 MAIN ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-5696
Mailing Address - Country:US
Mailing Address - Phone:866-961-5589
Mailing Address - Fax:866-961-5586
Practice Address - Street 1:1104 CORPORATE WAY
Practice Address - Street 2:SUITE 221
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3875
Practice Address - Country:US
Practice Address - Phone:866-961-5589
Practice Address - Fax:866-961-5586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Multi-Specialty