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General NPI Number Information
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NPI Number | 1184086019
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Entity Type | Organization
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Legal Business Name | LUNG CONSULTANT OF SOUTH FLORIDA, LLC
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Dates
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Enumeration Date | 03/21/2016
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 1250 ASTURIA AVE
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City | CORAL GABLES
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State | FL
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Zip | 33134-4736
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Country | US
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Telephone | 305-281-7063
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 ASTURIA AVE
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City | CORAL GABLES
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State | FL
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Zip | 33134-4736
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Country | US
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Telephone | 305-281-7063
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NESTOR CANCIO MORALES
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Credential | MD
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Telephone | 305-281-7063
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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 | ME122567
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License Number State | FL
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