Provider Demographics
NPI:1194287938
Name:BREATHE EASY RESPIRATORY SERVICES LLC
Entity type:Organization
Organization Name:BREATHE EASY RESPIRATORY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-460-0110
Mailing Address - Street 1:79 MAYFAIR LN
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8126
Mailing Address - Country:US
Mailing Address - Phone:561-460-0110
Mailing Address - Fax:
Practice Address - Street 1:79 MAYFAIR LN
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8126
Practice Address - Country:US
Practice Address - Phone:561-460-0110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010375300Medicaid