Provider Demographics
NPI:1952575797
Name:SOUTH FLORIDA PULMONARY AND CRITICAL CARE ASSOCIATES
Entity Type:Organization
Organization Name:SOUTH FLORIDA PULMONARY AND CRITICAL CARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
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 FL 1
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3250
Mailing Address - Country:US
Mailing Address - Phone:305-567-1999
Mailing Address - Fax:
Practice Address - Street 1:3181 CORAL WAY FL 1
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-3250
Practice Address - Country:US
Practice Address - Phone:305-567-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========BOtherHUMANA ID