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General NPI Number Information
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NPI Number | 1407842727
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Entity Type | Individual
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Provider Name | PAULA A LUNDGREN MD
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Gender | Female
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 2102 TRINITY OAKS BLVD # 205
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City | TRINITY
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State | FL
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Zip | 34655-4409
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Country | US
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Telephone | 727-462-2131
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Fax |
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Provider Business Mailing Address
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Address Line | 2995 DREW ST FL 2
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City | CLEARWATER
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State | FL
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Zip | 33759-3012
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Country | US
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Telephone | 727-532-1355
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Fax | 813-635-2613
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD067425L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | ME147205
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2012-01374
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME147205
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License Number State | FL
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