Provider Demographics
NPI:1104853498
Name:CARDIOPULMONARY ASSOCIATES OF THE TREASURE COAST PA
Entity Type:Organization
Organization Name:CARDIOPULMONARY ASSOCIATES OF THE TREASURE COAST PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-335-3500
Mailing Address - Street 1:1801 SE HILLMOOR DR
Mailing Address - Street 2:A110
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7553
Mailing Address - Country:US
Mailing Address - Phone:772-335-3500
Mailing Address - Fax:772-335-1361
Practice Address - Street 1:1801 SE HILLMOOR DR
Practice Address - Street 2:A110
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7553
Practice Address - Country:US
Practice Address - Phone:772-335-3500
Practice Address - Fax:772-335-1361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0032775174400000X
FLME842328174400000X
FLME93466174400000X
FL028759207Q00000X
FLOS8311207Q00000X
FLRN2784382363L00000X
FLARNP9293900363L00000X
FLARNP9236500363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty