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General NPI Number Information
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NPI Number | 1760689541
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Entity Type | Organization
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Legal Business Name | LUNG ASSOCIATES PA
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 08/22/2007
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Provider Practice Location Address
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Address Line | 203 3RD AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-1013
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Country | US
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Telephone | 941-741-8633
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Fax | 941-741-8632
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Provider Business Mailing Address
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Address Line | 203 3RD AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-1013
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Country | US
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Telephone | 941-741-8633
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Fax | 941-741-8632
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LISA RAMPERTAAP
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Credential | MD
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Telephone | 941-741-8633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0053985
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License Number State | FL
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