MEDICARE: HOF PULM & SLEEP, INC

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	207RP1001X	Pulmonary Disease Physician	ME101230	FL

General Provider Information

NPI Number	:	1174963326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOF PULM & SLEEP, INC

Provider Business Mailing Address
First Line	:	PO BOX 129
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33836-0129
Country	:	US
Telephone Number	:	863-419-7509
Fax Number	:	863-419-7824

Provider Business Practice Location Address
First Line	:	171 WEBB DR STE 2
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-3944
Country	:	US
Telephone Number	:	863-419-7509
Fax Number	:	863-419-7824

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	MAHMOUD F BAKEER
Credential	:	MD
Telephone Number	:	865-274-8047

Provider Enumeration Date	:	07/02/2013
Last Update Date	:	10/28/2013

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