Basic Information
Provider Information
NPI: 1447369954
EntityType: 2
ReplacementNPI:  
OrganizationName: PULMONARY FUNCTION READERS OF CLEARWATER
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 613 S MYRTLE AVE
Address2:  
City: CLEARWATER
State: FL
PostalCode: 337565615
CountryCode: US
TelephoneNumber: 7274414526
FaxNumber: 7274613253
Practice Location
Address1: 613 S MYRTLE AVE
Address2:  
City: CLEARWATER
State: FL
PostalCode: 337565615
CountryCode: US
TelephoneNumber: 7274414526
FaxNumber: 7274613253
Other Information
ProviderEnumerationDate: 08/29/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: TINSLEY
AuthorizedOfficialFirstName: STEVEN
AuthorizedOfficialMiddleName: BARRY
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 7274414526
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XME51360FLY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


Home