MEDICARE: ADVANCED LUNG AND SLEEP DISORDERS CONSULTANTS P A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME0072885	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023281060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED LUNG AND SLEEP DISORDERS CONSULTANTS P A

Provider Business Mailing Address
First Line	:	6185 54TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33709-1807
Country	:	US
Telephone Number	:	727-545-1199
Fax Number	:	727-545-5599

Provider Business Practice Location Address
First Line	:	6185 54TH AVE N
Second Line	:
City	:	KENNETH CITY
State	:	FL
Zip	:	33709-1807
Country	:	US
Telephone Number	:	727-545-1199
Fax Number	:	727-545-5599

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ASHOK MITTAL
Credential	:	MD
Telephone Number	:	727-545-1199

Provider Enumeration Date	:	04/10/2008
Last Update Date	:	02/23/2010

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