Basic Information
| Provider Information | |||||||||
| NPI: | 1417490822 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUNCOAST CHEST PHYSICIANS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1345 W BAY DR | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | LARGO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337702282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274414526 | ||||||||
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| Address1: | 1345 W BAY DR | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | LARGO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337702282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274414526 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2016 | ||||||||
| LastUpdateDate: | 12/02/2016 | ||||||||
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| AuthorizedOfficialLastName: | TINSLEY | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | BARRY | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7274414526 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | ME51360 | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.