Provider Demographics
NPI:1861813461
Name:PULLMONARY AND CRITICAL CARE ASSOCIATES
Entity Type:Organization
Organization Name:PULLMONARY AND CRITICAL CARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:Z
Authorized Official - Last Name:MILLSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-276-2044
Mailing Address - Street 1:1893 KINGSLEY AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4491
Mailing Address - Country:US
Mailing Address - Phone:904-276-2044
Mailing Address - Fax:904-276-2106
Practice Address - Street 1:1658 ST VINCENTS WAY
Practice Address - Street 2:SUITE 240
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-8447
Practice Address - Country:US
Practice Address - Phone:904-276-2044
Practice Address - Fax:904-276-2106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-27
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty