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General NPI Number Information
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NPI Number | 1114929643
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Entity Type | Organization
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Legal Business Name | PULMONARY PRACTICE ASSOCIATES MD PA
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 1075 TOWN CENTER DR
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City | ORANGE CITY
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State | FL
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Zip | 32763-8360
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Country | US
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Telephone | 386-917-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 1075 TOWN CENTER DR
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City | ORANGE CITY
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State | FL
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Zip | 32763-8360
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Country | US
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Telephone | 386-917-0333
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | NATASHA SIERRA
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Credential |
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Telephone | 386-917-0333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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