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General NPI Number Information
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NPI Number | 1427294974
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Entity Type | Organization
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Legal Business Name | PULMONARY INSTITUTE, P.A.
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 12/03/2010
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Provider Practice Location Address
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Address Line | 8803 FUTURES DR STE 7
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City | ORLANDO
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State | FL
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Zip | 32819-9076
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Country | US
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Telephone | 407-219-5936
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Fax | 407-480-3455
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Provider Business Mailing Address
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Address Line | 8803 FUTURES DR STE 7
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City | ORLANDO
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State | FL
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Zip | 32819-9076
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Country | US
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Telephone | 407-219-5936
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Fax | 407-480-3455
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARISELLY MEDINA-IRIZARRY
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Credential | MD
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Telephone | 407-405-0722
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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 | ME93134
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License Number State | FL
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