MEDICARE: FLORIDA LUNG SPECIALISTS, PA

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

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	:	1194701375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA LUNG SPECIALISTS, PA

Provider Business Mailing Address
First Line	:	1588 CITRUS MEDICAL COURT
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-4547
Country	:	US
Telephone Number	:	407-733-0275
Fax Number	:	407-435-9671

Provider Business Practice Location Address
First Line	:	1588 CITRUS MEDICAL COURT
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-4547
Country	:	US
Telephone Number	:	407-733-0275
Fax Number	:	407-435-9671

Authorized Official
Title or Position	:	PRACTITIONER MD
Name	:	DR. SHAHID SAMY
Credential	:	MD
Telephone Number	:	407-733-0275

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	10/07/2021

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