Provider Demographics
NPI:1770653750
Name:PULMISERV PSC
Entity Type:Organization
Organization Name:PULMISERV PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PULMONARY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LEIDE
Authorized Official - Middle Name:AILED
Authorized Official - Last Name:ACEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:RESPIRATORY THERAPIS
Authorized Official - Phone:787-787-5151
Mailing Address - Street 1:PMB 2116 PO BOX 6029
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-6029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:JARDINES DE COUNTRY CLUB
Practice Address - Street 2:165 DA 4
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-0000
Practice Address - Country:US
Practice Address - Phone:787-787-5151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital