Provider Demographics
NPI:1992883383
Name:PULMONARY PROVIDERS, INC.
Entity type:Organization
Organization Name:PULMONARY PROVIDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVSHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-302-2900
Mailing Address - Street 1:21408 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1144
Mailing Address - Country:US
Mailing Address - Phone:305-830-0202
Mailing Address - Fax:305-830-0204
Practice Address - Street 1:21408 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1144
Practice Address - Country:US
Practice Address - Phone:305-830-0202
Practice Address - Fax:305-830-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL051640332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies