Provider Demographics
NPI:1194380675
Name:PULSE MEDICAL GROUP INC.
Entity Type:Organization
Organization Name:PULSE MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:MAULDEN
Authorized Official - Last Name:NOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:850-454-5301
Mailing Address - Street 1:6202 N 9TH AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8293
Mailing Address - Country:US
Mailing Address - Phone:850-857-9775
Mailing Address - Fax:850-857-9847
Practice Address - Street 1:6202 N 9TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8293
Practice Address - Country:US
Practice Address - Phone:850-857-9775
Practice Address - Fax:850-857-9847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty