Provider Demographics
NPI:1386622629
Name:RESPIRATORY CRITICAL CARE AND SLEEP MEDICINE ASSOCIATES,INC
Entity type:Organization
Organization Name:RESPIRATORY CRITICAL CARE AND SLEEP MEDICINE ASSOCIATES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-605-7004
Mailing Address - Street 1:1325 SAN MARCO BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8567
Mailing Address - Country:US
Mailing Address - Phone:904-253-6910
Mailing Address - Fax:904-253-6964
Practice Address - Street 1:1325 SAN MARCO BLVD STE 300
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8567
Practice Address - Country:US
Practice Address - Phone:904-253-6910
Practice Address - Fax:904-253-6964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-06
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38837OtherBCBS OF FLORIDA
FL262200900Medicaid
FL5740668OtherAETNA
FL5740668OtherAETNA
FLK0918Medicare UPIN