Provider Demographics
NPI:1528697588
Name:ASSOCIATES OF PULMONARY MEDICINE LLC
Entity type:Organization
Organization Name:ASSOCIATES OF PULMONARY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KASEM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARNVITAYAPONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-283-4428
Mailing Address - Street 1:2221 SE OCEAN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3341
Mailing Address - Country:US
Mailing Address - Phone:772-283-4428
Mailing Address - Fax:
Practice Address - Street 1:8980 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-3482
Practice Address - Country:US
Practice Address - Phone:772-283-4428
Practice Address - Fax:772-600-1719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty