Organization
PULMONARY CC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAMBURA N. MKONO M.D. (OWNER)
(561) 777-5308
Entity
Organization
Contact information
Practice address
10075 S JOG RD, 311, BOYNTON BEACH, FL 33437-3535
(561) 777-5308
(561) 303-2131
Mailing address
6615 W BOYNTON BEACH BLVD PMB 101, BOYNTON BEACH, FL 33437-3536
(561) 777-5308
(561) 303-2131
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME110611
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007946700
—
FL
Enumeration date
12/01/2012
Last updated
05/05/2022
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