Provider Demographics
NPI:1811932239
Name:PULMONARY ASSOCIATES OF BRANDON PA
Entity type:Organization
Organization Name:PULMONARY ASSOCIATES OF BRANDON PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-681-8813
Mailing Address - Street 1:910 OAKFIELD DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4925
Mailing Address - Country:US
Mailing Address - Phone:813-681-4413
Mailing Address - Fax:813-684-7299
Practice Address - Street 1:910 OAKFIELD DR
Practice Address - Street 2:SUITE 102
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4925
Practice Address - Country:US
Practice Address - Phone:813-681-4413
Practice Address - Fax:813-684-7299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1811932239OtherNPPES
FL1811932239OtherNPPES