Organization
PULSE, PA
Active
Organization
PULSE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE BACKUS-WADE (PRACTICE MANAGER)
(941) 629-2111
Entity
Organization
Contact information
Practice address
3420 TAMIAMI TRL UNIT 2, PORT CHARLOTTE, FL 33952-8126
(941) 629-2111
(941) 627-5377
Mailing address
3420 TAMIAMI TRL UNIT 2, PORT CHARLOTTE, FL 33952-8126
(941) 629-2111
(941) 627-5377
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
ME107666
FL
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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