Provider Demographics
NPI:1710229588
Name:PEDIATRIC PULMONARY SERVICES INC.
Entity type:Organization
Organization Name:PEDIATRIC PULMONARY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMUALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DANGERVIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-417-3957
Mailing Address - Street 1:13155 WEST DIXIE HYGHWAY
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4130
Mailing Address - Country:US
Mailing Address - Phone:786-288-0617
Mailing Address - Fax:305-947-9823
Practice Address - Street 1:13155 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4130
Practice Address - Country:US
Practice Address - Phone:786-288-0617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Single Specialty