Provider Demographics
NPI:1205054483
Name:SOUTH FLORIDA PUL,MONARY AND CRITICAL CARE
Entity type:Organization
Organization Name:SOUTH FLORIDA PUL,MONARY AND CRITICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:A
Authorized Official - Last Name:REDONDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-567-1999
Mailing Address - Street 1:3181 CORAL WAY
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3216
Mailing Address - Country:US
Mailing Address - Phone:305-567-1999
Mailing Address - Fax:305-567-9309
Practice Address - Street 1:3181 CORAL WAY
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-3216
Practice Address - Country:US
Practice Address - Phone:305-567-1999
Practice Address - Fax:305-567-9309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID
FL77870Medicare ID - Type UnspecifiedMEDICARE