Healthcare Provider Details

I. General information

NPI: 1689740318
Provider Name (Legal Business Name): PERSONAL PULMONARY HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 S. HWY. 441
LADY LAKE FL
32159
US

IV. Provider business mailing address

835 S. HWY 441
LADY LAKE FL
32159
US

V. Phone/Fax

Practice location:
  • Phone: 352-343-8888
  • Fax: 352-343-5386
Mailing address:
  • Phone: 352-343-8888
  • Fax: 352-343-5386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number484
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateFL

VIII. Authorized Official

Name: LORI KAPLAN
Title or Position: PRESIDENT
Credential: RPH
Phone: 352-343-8888