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General NPI Number Information
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NPI Number | 1134620164
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Entity Type | Organization
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Legal Business Name | ADVANCED CRITICAL CARE LUNG AND SLEEP, LLC
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Dates
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Enumeration Date | 02/25/2018
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Last Update Date | 01/14/2019
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Provider Practice Location Address
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Address Line | 6101 PINE RIDGE RD FL 3
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City | NAPLES
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State | FL
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Zip | 34119
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Country | US
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Telephone | 239-920-4446
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Fax | 239-920-4447
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Provider Business Mailing Address
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Address Line | 2430 VANDERBILT BEACH RD STE 108
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City | NAPLES
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State | FL
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Zip | 34109-2654
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Country | US
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Telephone | 239-810-0677
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Fax | 239-920-4447
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Authorized Official
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Title or Position | MANAGING PHYSICIAN
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Name | DR. SADIQ AL-NAKEEB
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Credential | MD
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Telephone | 239-810-0677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | 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 | 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 #4
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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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