Provider Demographics
NPI:1629272828
Name:PEDIATRIC PULMONOLOGY GROUP OF SOUTH FLORIDA, LLC
Entity Type:Organization
Organization Name:PEDIATRIC PULMONOLOGY GROUP OF SOUTH FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOISES
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-662-8380
Mailing Address - Street 1:3200 SW 60TH CT
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4000
Mailing Address - Country:US
Mailing Address - Phone:305-662-8380
Mailing Address - Fax:305-663-8417
Practice Address - Street 1:3200 SW 60TH CT
Practice Address - Street 2:SUITE 203
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4000
Practice Address - Country:US
Practice Address - Phone:305-662-8380
Practice Address - Fax:305-663-8417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Single Specialty