Organization Active NPI

Breathewell Pulmonary Clinic LLC

  • Pulmonary Disease Physician
  • Tampa, FL
National Provider Identifier
1992537856
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
BREATHEWELL PULMONARY CLINIC LLC
Practice address
3450 E Fletcher Ave Ste 260
Tampa, FL 33613-4697
Phone
(813) 419-3108
Fax
(813) 482-0542
NPI assigned
Aug 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amie Zamora
Title
Credentialing
Phone
(888) 556-2742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

3450 E Fletcher Ave Ste 260
Tampa, FL 33613-4697

Mailing address

9628 Charlesberg Dr
Tampa, FL 33635-1638
Phone (813) 419-3108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241014001809 FL Part B Supplier - Clinic/Group Practice 3779024237 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

3450 E Fletcher Ave
Ste 260
Tampa, FL 33613
Phone (813) 419-3108

4129 N Armenia Ave
Ste 208
Tampa, FL 33607
Phone (813) 419-3108

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1992537856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9628 CHARLESBERG DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336351638",
            "telephone_number": "813-419-3108",
            "fax_number": "813-482-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 E FLETCHER AVE STE 260",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134697",
            "telephone_number": "813-419-3108",
            "fax_number": "813-482-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREATHEWELL PULMONARY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "ZAMORA",
        "authorized_official_first_name": "AMIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "888-556-2742"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.