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General NPI Number Information
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NPI Number | 1043429038
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Entity Type | Organization
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Legal Business Name | PULMONARY ASSOCIATES OF PEMBROKE PINES, INC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 703 N FLAMINGO RD
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1006
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Country | US
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Telephone | 954-443-7147
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Fax |
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Provider Business Mailing Address
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Address Line | 1725 E HIGHWAY 50 STE C
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City | CLERMONT
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State | FL
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Zip | 34711-5188
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Country | US
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Telephone | 352-243-5651
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. LORN LEITMAN
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Credential |
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Telephone | 305-227-5176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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