Provider Demographics
NPI:1124146642
Name:VASSOR, PIERRE HAROLD (RRT)
Entity type:Individual
Prefix:
First Name:PIERRE
Middle Name:HAROLD
Last Name:VASSOR
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2856 SW 176TH TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5557
Mailing Address - Country:US
Mailing Address - Phone:954-441-0590
Mailing Address - Fax:
Practice Address - Street 1:2856 SW 176TH TER
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5557
Practice Address - Country:US
Practice Address - Phone:954-441-0590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT29602279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8843775Medicaid