Provider Demographics
NPI:1487699948
Name:PNEUMOCARE DIAGNOSTIC INC
Entity type:Organization
Organization Name:PNEUMOCARE DIAGNOSTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:AFANADOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-275-6424
Mailing Address - Street 1:10240 SW 56TH ST #110
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165
Mailing Address - Country:US
Mailing Address - Phone:305-275-6424
Mailing Address - Fax:305-275-6425
Practice Address - Street 1:16201 SW 95TH AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-3459
Practice Address - Country:US
Practice Address - Phone:305-238-8198
Practice Address - Fax:305-238-8195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225B00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPulmonary Function TechnologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE9115Medicare ID - Type UnspecifiedMEDICARE