Healthcare Provider Details

I. General information

NPI: 1467464990
Provider Name (Legal Business Name): AMERICAN LUNG AND SLEEP DISORDERS CONSULTANTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6223 66TH STREET NORTH
PINELLAS PARK FL
33781-5025
US

IV. Provider business mailing address

6223 66TH STREET NORTH
PINELLAS PARK FL
33781-5025
US

V. Phone/Fax

Practice location:
  • Phone: 727-528-4900
  • Fax: 727-528-8628
Mailing address:
  • Phone: 727-528-4900
  • Fax: 727-528-8628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME68290
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberME68290
License Number StateFL

VIII. Authorized Official

Name: RAJESH AGRAWAL
Title or Position: OWNER
Credential: MD
Phone: 727-528-4900