Provider Demographics
NPI:1871036236
Name:TREASURE COAST PULMONARY MEDICINE, P.A.
Entity Type:Organization
Organization Name:TREASURE COAST PULMONARY MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVEK
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-485-3695
Mailing Address - Street 1:10380 SW VILLAGE CENTER DR
Mailing Address - Street 2:319
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-1931
Mailing Address - Country:US
Mailing Address - Phone:772-485-3695
Mailing Address - Fax:
Practice Address - Street 1:10380 SW VILLAGE CENTER DR
Practice Address - Street 2:319
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-1931
Practice Address - Country:US
Practice Address - Phone:772-485-3695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99553207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty