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NPI Code Detail

MEDICARE: LAKE PULMONARY CRITICAL CARE

MEDICARE: LAKE PULMONARY CRITICAL CARE
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1184850802
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKE PULMONARY CRITICAL CARE
Provider Business Mailing Address
First Line : 1876 NIGHTINGALE LN
Second Line :
City : TAVARES
State : FL
Zip : 32778-4359
Country : US
Telephone Number : 352-742-4447
Fax Number : 352-742-4448
Provider Business Practice Location Address
First Line : 1876 NIGHTINGALE LN
Second Line :
City : TAVARES
State : FL
Zip : 32778-4359
Country : US
Telephone Number : 352-742-4447
Fax Number : 352-742-4448
Authorized Official
Title or Position : OWNER
Name : DR. FRANK JOSE MONTOYA
Credential : MD
Telephone Number : 352-742-4447
Provider Enumeration Date : 06/09/2009
Last Update Date : 01/13/2011

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1265667331 — DR. ALBA DAMARIS RIVERA-DIAZ MD, LND
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Practice Fax: 352-742-4447

Directions to “LAKE PULMONARY CRITICAL CARE ” Practice Location

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