Provider Demographics
NPI:1700293545
Name:SOUTHWEST PULMONARY SERVICES CORP
Entity type:Organization
Organization Name:SOUTHWEST PULMONARY SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESPIRATORY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NEVINSTHON
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALCINDOR
Authorized Official - Suffix:SR
Authorized Official - Credentials:CRT
Authorized Official - Phone:305-812-0206
Mailing Address - Street 1:1938 SE 22ND CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-1238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1938 SE 22ND CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-1238
Practice Address - Country:US
Practice Address - Phone:305-812-0206
Practice Address - Fax:786-404-3711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT13323207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty