| Pulmonology And Sleep Center Llc | |
|
2300 South Congress Avenue Suite 101 Boynton Beach FL 33426 | |
| (561) 374-8911 | |
| (561) 374-8911 |
| Full Name | Pulmonology And Sleep Center Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2300 South Congress Avenue Suite 101, Boynton Beach, Florida |
| Authorized Official Name and Position | Frederick Tackey (MANAGING MEMBER) |
| Authorized Official Contact | 5613748919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pulmonology And Sleep Center Llc Po Box 550 Boynton Beach FL 33425-0550 Ph: (561) 374-8919 | Pulmonology And Sleep Center Llc 2300 South Congress Avenue Suite 101 Boynton Beach FL 33426 Ph: (561) 374-8911 |
| NPI Number | 1447266085 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 10/29/2012 |
| Medicare PECOS PAC ID | 7113179649 |
|---|---|
| Medicare Enrollment ID | O20121210000199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447266085 | NPI | - | NPPES |
| 377890800 | Medicaid | FL |
| Provider Name | Frederick S Tackey |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1689743445 PECOS PAC ID: 2769450154 Enrollment ID: I20040923000202 |
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