Provider Demographics
NPI:1851478994
Name:GULF COAST PULMONARY MEDICINE P.A.
Entity Type:Organization
Organization Name:GULF COAST PULMONARY MEDICINE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPADIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-625-7775
Mailing Address - Street 1:PO BOX 496593
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949-6593
Mailing Address - Country:US
Mailing Address - Phone:941-625-7775
Mailing Address - Fax:941-625-2226
Practice Address - Street 1:2400 HARBOR BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5052
Practice Address - Country:US
Practice Address - Phone:941-625-7775
Practice Address - Fax:941-625-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84311207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8661Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER