Provider Demographics
NPI:1528112596
Name:BROWARD PULMONARY CONSULTANTS PA
Entity type:Organization
Organization Name:BROWARD PULMONARY CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOYOS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-975-3113
Mailing Address - Street 1:3369 BRADENHAM LN
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-7322
Mailing Address - Country:US
Mailing Address - Phone:954-975-3113
Mailing Address - Fax:
Practice Address - Street 1:2825 N STATE ROAD 7
Practice Address - Street 2:SUITE 201
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5737
Practice Address - Country:US
Practice Address - Phone:954-975-3113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7260207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9688Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER